Adrian Streinu-Cercel

Alina Cristina Neguț

Anca Streinu-Cercel

Mihai Lazăr

Oana Streinu-Cercel

BMC Infectious Diseases

PubMed

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POSTER PRESENTATION Open Access
Long survivor family with HIV infection. Case
presentation
Alina Cristina Neguț1,2*, Anca Streinu-Cercel1,2, Oana Streinu-Cercel1,2, Mihai Lazăr1,2, Adrian Streinu-Cercel1,2
From The 9th Edition of the Scientific Days of the National Institute for Infectious Diseases Prof Dr Matei Bals
Bucharest, Romania. 23-25 October 2013
Background
After the advent of highly active antiretroviral therapy,
HIV infection has turned into a chronic disease and the
patient’s profile has changed dramatically. We are now
treating patients that are active both socially and profes-
sionally, in whom virological response has already been
achieved and quality of life has become of utmost impor-
tance, directly correlated with the management of drug-
associated adverse reactions. To describe this new patient
profile, we present the management of a young family,
living with HIV for more than 7 years.
Case report
A family was referred to our clinic in the summer of
2012, by the Italian HIV Clinic where they had been
under medical evaluation for over 7 years. They had
tested positive at the routine pregnancy test 7 years back,
when the mother was started on lopinavir/r, lamivudine
+zidovudine. She gave birth to a healthy HIV-negative
girl, who received postpartum prophylaxis for 3 months
(as per Italian protocol). After delivery the mother was
switched to efavirenz plus lamivudine+zidovudine, the
same therapy as her husband’s, a regimen they would
both take for 7 years.
In 2012 they moved to Romania and started attending
our clinic. Both had undetectable viral loads and high
CD4 counts (>700 cells/cmm), consistent with their med-
ical history. However, both complained of lipodystrophy.
The female also complained of peripheral neuropathy,
sleep disturbance, vivid nightmares while the male pre-
sented increased serum cholesterol and triglycerides,
irritability and sleep disturbance.
Because their quality of life had started to decrease,
after psychological evaluation and support, therapy was
changed to raltegravir, abacavir+lamivudine (both had
negative HLA-B*5701). This regimen was well tolerated,
the symptoms improved, the CD4 count remained high,
the male’s lipid profile returned to normal, and dual-
energy X-ray absorptiometry (DEXA) evaluation at
3 months showed an almost normal lipid distribution for
both patients, with a slight tendency toward android
abdominal lipid distribution for the female patient. She
remained undetectable (data available for 1 year follow-
up), however, in the case of the male patient HIV-RNA
rose to 320 copies/mL at 3 months, possibly associated
with the impact of the drug regimen on viral reservoirs. At
6 months, the viral load became undetectable and
remained that way to date.
Conclusion
Correct and prompt management of adverse reactions is
an important aspect in patients on antiretroviral therapy,
since this may lead to improved quality of life and better
social and professional integration of patients.
Authors’ details
1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
2National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest,
Romania.
Published: 16 December 2013
doi:10.1186/1471-2334-13-S1-P56
Cite this article as: Neguț et al.: Long survivor family with HIV infection.
Case presentation. BMC Infectious Diseases 2013 13(Suppl 1):P56.
* Correspondence: negoitza_alina@yahoo.com
1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
Full list of author information is available at the end of the article
Neguț et al. BMC Infectious Diseases 2013, 13(Suppl 1):P56
http://www.biomedcentral.com/1471-2334/13/S1/P56
© 2013 Neguț et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


Long survivor family with HIV infection. Case presentation

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Long survivor family with HIV infection. Case presentation

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