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Case 3: Laboratory Monitoring after Initiating Antiretroviral Therapy

You answered:

A The CD4 cell count is the most important laboratory test to obtain at 1 month after starting antiretroviral therapy.

This answer is incorrect. Although monitoring CD4 cell count responses provides important information regarding the immunologic response to antiretroviral therapy, responses vary widely and it is not the most important laboratory test to perform 1 month after starting therapy. In general, a follow-up CD4 count is not recommended until the patient has been on therapy for at least 8 to 12 weeks. The initial HIV RNA response provides the best early feedback regarding the patient’s response to antiretroviral medications.

Choose another answer:

B A follow-up HIV RNA value should first be checked 10 to 12 weeks after starting therapy.
C A follow-up HIV RNA value should first be checked 2 to 8 weeks after starting therapy.
D A decrease in the patient's baseline HIV RNA value of 112,000 copies/ml to 55,000 copies/ml 4 weeks after starting therapy would indicate an excellent early response to antiretroviral therapy.

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