48-yr-old man with HIV for 12 years presented 1 year after his last visit with a history of methamphetamine use, inconsistent engagement in care, and a new diabetes diagnosis. He reported no recent ART and no meth use for about 8 months. On returning to care, his viral load was 250,000 copies/mL, the CD4 count was 230 cells/mm3, creatinine levels were elevated, and genotype testing found a K103N mutation. He was motivated to resume ART. Drs. Scully and Hoffmann evaluate the patient’s new ART options in light of his clinical viremia and comorbidities.

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Related Guidance and Guidelines
NYSDOH AI Clinical Guidelines Program:

• ChemSex: Questions and Answers
• HIV Resistance Assays
• Resource: ART Drug-Drug Interactions
• Stimulant Use Clinical Guidance
• Substance Use Harm Reduction in Medical Care
• Use of Injectable CAB/RPV LA as Replacement ART in Virally Suppressed Adults

Clinical Info HIV.gov:

• Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV
• Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV