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Last week, we asked which antiretroviral regimen you would prescribe for an HIV-infected woman who is about to undergo renal transplantation and is ready to try antiretroviral therapy (ART) again, having struggled with adherence in the past. This week, two experts describe how they would handle the case.
A 47-year-old African-American woman with a history of hypertension and diabetes was diagnosed with HIV infection in 2005. At the time, her CD4 count was 780 cells/mm3, and her viral load was 1200 copies/mL; other notable baseline laboratory results included a serum creatinine level of 3.3 mg/dL and heavy proteinuria on urinalysis. A renal ultrasound demonstrated small kidneys, suggestive of advanced diabetic and hypertensive renal d…