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Case 1: Indications for Resistance Testing

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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.

This answer is incorrect. This patient appears to be experiencing virologic failure. Resistance testing is clearly indicated to help determine if resistance to antiretroviral agents in his current regimen is contributing to this virologic failure, and to assist in selecting the best medications to use if the regimen is changed.

A A 28-year-old man who has just been diagnosed with primary (acute) HIV infection.
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.
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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