Case 3: Laboratory Monitoring after Initiating Antiretroviral Therapy

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Case last updated: October 16, 2006

A 47-year-old HIV-infected woman was recently diagnosed with HIV infection, and initial labs have shown a CD4 count of 238 cells/mm3 and HIV RNA level of 112,000 copies/ml. After several visits to the clinic and repeat laboratory studies that show similar results, she starts on an antiretroviral therapy regimen of tenofovir DF (Viread) plus lamivudine (Epivir) plus lopinavir-ritonavir (Kaletra). The patient intermittently drinks alcohol and occasionally smokes marijuana.

According to the October 2006 DHHS antiretroviral guidelines, which of the following is TRUE regarding laboratory monitoring after starting this patient on antiretroviral therapy.

	The CD4 cell count is the most important laboratory test to obtain at 1 month after starting antiretroviral therapy.
	A follow-up HIV RNA value should first be checked 10-12 weeks after starting therapy.
	A follow-up HIV RNA value should first be checked 2-8 weeks after starting therapy.
	If the patient's baseline HIV RNA value of 112,000 copies/ml decrease to 55,000 copies/ml 4 weeks after starting therapy, it would indicate an excellent early response to antiretroviral therapy.