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Updated September 29, 2012

Case 2: Antiretroviral Regimens

Author: David H. Spach, MD

A 36-year-old woman has recently been diagnosed with HIV infection. Her initial laboratory studies show a CD4 count of 100 cells/mm3 and HIV RNA of 87,500 copies/ml. Repeat laboratory studies performed one month later show similar results. She has not had any HIV-related complications history. Her physical examination is normal. She is very interested in starting antiretroviral therapy. Her only medication that she takes is trimethoprim-sulfamethoxazole (Bactrim, Septra).

According to the 2012 HHS Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents, which of the following is considerd a preferred initial combination regimen for antiretroviral-naive patients?

A Zidovudine-lamivudine (Combivir) plus efavirenz (Sustiva)
B Tenofovir-emtricitabine (Truvada) plus ritonavir (Norvir) plus darunavir (Prezista)
C Abacavir-lamivudine (Epzicom) plus raltegravir (Isentress)
D Tenofovir-emtricitabine (Truvada) plus lopinavir-ritonavir (Kaletra)