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Case 4: Antiretroviral Therapy for Acute (Primary) HIV

You answered:

C More than 90% persons with acute HIV who initiate 4-drug antiretroviral therapy prior to seroconversion (and continue therapy for 24 months) will eventually maintain long-term virologic control without antiretroviral therapy.

This answer is incorrect. Although early data were promising using this approach, long-term follow-up has shown that most of the patients eventually failed to maintain control of HIV.

A Fewer than 30% of persons with acute HIV infection treated with HAART will achieve an HIV RNA level less than 400 copies/ml, mainly as a result of the very high HIV RNA levels and the weak immune response at this stage.
B Transmission of antiretroviral-resistant HIV has been documented through sexual, parenteral, and vertical routes. Persons who acquire antiretroviral resistant HIV are more likely to have failures with antiretroviral therapy.
D Antiretroviral therapy initiated within 180 days of acquiring HIV clearly provides long-term clinical benefit when compared with deferred antiretroviral therapy (given for chronic HIV when the CD4 count has deceased to less than 500 cells/mm3).

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