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Case 1: Indications for Resistance Testing

You answered:

B A 32-year-old woman has a CD4 count of 284 cells/mm3 and a HIV RNA level of 61,000 copies/ml. She has never taken antiretroviral therapy, but is planning to start on her first antiretroviral regimen within the next 3-4 months.

This answer is incorrect. The December 2007 DHHS antiretroviral therapy guidelines recommend performing resistance testing prior to initiating antiretroviral therapy in persons chronically infected with HIV (if they have not previously had a resistance test). These guideliens recommend performing resistance testing in the setting of chronic HIV infection at the time a patient enters into care for their HIV disease.

Choose another answer:

A A 28-year-old man who has just been diagnosed with primary (acute) HIV infection.
C A 41-year-old man on tenofovir plus emtricitabine (Truvada) plus ritonavir (Norvir) plus atazanavir (Reyataz) whose last four HIV RNA measurements were 281, 765, 1532, and 3036 copies/ml.
D A 35-year-old woman who previously had an HIV RNA level of 16,700 copies/ml while taking the regimen of stavudine (Zerit) plus lamivudine (Epivir) plus efavirenz (Sustiva). She admits to spotty adherence while taking that regimen and she discontinued all of her antiretroviral medications 24 weeks ago. She now wants to restart antiretroviral therapy and states she is highly motivated to have excellent adherence.

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