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Case 3: Resistance to Non-Nucleoside Reverse Transcriptase Inhibitors

You answered:

C Although the K103N mutation reflects resistance to efavirenz, the patient should have an excellent virologic response to delavirdine.

This answer is incorrect. The K103N mutation causes high-level resistance to efavirenz as well as cross-resistance to nevirapine and delavirdine.

A The patient is not likely to have a significant virologic response to efavirenz or nevirapine.
B Although the K103N mutation reflects resistance to efavirenz, the patient should have an excellent virologic response to nevirapine.
D If the patient is placed back on efavirenz and the K103N mutation remerges, efavirenz should be continued because the presence of the K103N mutation will markedly reduce viral fitness.

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