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Today, antiretroviral therapies are successful in chronic HIV infection and have improved survival outcome. However antiretroviral drug resistance, coinfection, comorbidity and management of drug interactions are prominent in long-term treatments. In this study, we aimed to present the management of antiretroviral treatment in the light of high levels of darunavir resistance in a patient who is incompatible with antiretroviral therapies. HIV-1 drug resistance analysis was frequently applied because our patient was not compatible with the treatment. Minimally interacting agents with antiretroviral therapy could be selected in developing pulmonary tuberculosis. In addition, in the developing acute renal failure, genetic barrier anxiety could be left behind. Our findings suggest that HIV-1 drug resistance analysis should be an integral part of the management of antiretroviral treatment in developing co-infections and comorbidities in an incompatible patient.

Background and Objectives: CD4 + T lymphocytes are the primary targets of HIV infection. Absolute CD4 + T lymphocyte count is an indicator of immune competence in evaluating the stage of the disease, delayed diagnosis, need for prophylaxis against opportunistic infections and the treatment success. In this study, we aimed to compare standard flow cytometry and point of care CD4 + T lymphocyte measurement analysis techniques in terms of cost, effectiveness, compliance, reliability, time and the use of this method for disease progression for the HIV-1 infected Turkish patients. Methods: This study includes 116 patients with chronic HIV infection. Patients under treatment, over 18 years old are included. CD4 + T lymphocyte count and percentage were enumerated by flow cytometry, which is the gold standard method. Also hemoglobin level was studied. These parameters were also studied with a new POC method called Cartridge. The data obtained by two methods are compared. Results: Of the 113 patients, 96 (85%) were male, 17 (15%) were female, and the mean age of the group was 43. When compared two methods, Spearman's correlation coefficients demonstrated good correlation for hemoglobin (r = 0.764). For CD4 + T lymphocyte measurements, correlation coefficients were lower (r = 0.725 and 0.515 respectively) but still statistically significant (p < 0.001). According to Bland-Altman analysis, the average difference for hemoglobin shows strong correlation for different measurements. Conclusions: In resource-limited countries, not all patients can receive ART. Therefore, this test is important in order to instantly detect patients who are in urgent compliance to initiate treatment with CD4 measurement. Hemoglobin measurement is the best parameter between the two methods that can be compared in our opinion because it is determined in a more standardized way. As we found in our study, the high correlation of hemoglobin values may give an idea about the reliability of the new method.

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