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Tom Delbanco, MD; Erin Hartman, MS
From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 1999;282:1176.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

At Medical Grand Rounds in April 1998, Dr Harvey Makadon discussed the care of Mr K, a 41-year-old self-employed man with asymptomatic human immunodeficiency virus (HIV) infection that was likely contracted in 1990.¹ At the time of diagnosis, Mr K started taking zidovudine, 200 to 300 mg/d. Frequent CD4 cell counts have been 500/mm³(0.50 x 10⁹) or higher, and several measures of HIV viral load, including ultrasensitive RNA studies, were unable to detect any virus. Fighting clinical depression that started with his diagnosis and was exacerbated in late 1997 by his partner's death from acquired immunodeficiency syndrome, Mr K began to drink increasing amounts of wine and discontinued zidovudine 6 months prior to the Rounds. Dr Makadon discussed current indications for multiple drug therapy in patients with asymptomatic disease and suggested that even in the absence of symptoms or increasing viral load, . . . [Full Text of this Article]

MR K, THE PATIENT



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