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    usmlemate is offline Junior Member
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    Antiretroviral Regimens for Initial Therapy

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    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.

    According to the March 2004 DHHS Guidelines for the Use of Antiretroviral Agents, which of the following statements is TRUE?

    A. The regimen zidovudine plus lamivudine (Combivir) plus indinavir (Crixivan) is considered a preferred regimen.

    B. The regimen tenofovir DF (Viread) plus lamivudine (Epivir) plus efavirenz (Sustiva) is considered a preferred regimen.

    C. The combination of abacavir (Ziagen) plus tenofovir DF (Viread) plus lamivudine (Epivir) is considered an alternative regimen.

    D. The regimen zidovudine (Retrovir) plus stavudine (Zerit) plus lopinavir-ritonavir (Kaletra) is considered a preferred regimen.

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    Asclepius1 is offline Ultimate Member 537 points
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    B. The regimen tenofovir DF (Viread) plus lamivudine (Epivir

    My guess is B. The regimen tenofovir DF (Viread) plus lamivudine (Epivir) plus efavirenz (Sustiva) is considered a preferred regimen.

  3. #3
    usmlemate is offline Junior Member
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    Re: Antiretroviral Regimens for Initial Therapy

    Quote Originally Posted by usmlemate
    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.

    According to the March 2004 DHHS Guidelines for the Use of Antiretroviral Agents, which of the following statements is TRUE?

    A. The regimen zidovudine plus lamivudine (Combivir) plus indinavir (Crixivan) is considered a preferred regimen.

    B. The regimen tenofovir DF (Viread) plus lamivudine (Epivir) plus efavirenz (Sustiva) is considered a preferred regimen.

    C. The combination of abacavir (Ziagen) plus tenofovir DF (Viread) plus lamivudine (Epivir) is considered an alternative regimen.

    D. The regimen zidovudine (Retrovir) plus stavudine (Zerit) plus lopinavir-ritonavir (Kaletra) is considered a preferred regimen.
    Answer B is correct. This regimen tenofovir DF plus lamivudine plus efavirenz is considered a preferred regimen based on data that have shown excellent virologic response and durability. There are several options for use of efavirenz as part of a recommended preferred regimen, namely efavirenz plus lamivudine plus either zidovudine, tenofovir DF, or stavudine (Zerit).

    Answer A is incorrect. Although the regimen of zidovudine plus lamivudine plus indinavir was widely used in the late 1990s and was effective, this regimen is no longer considered a preferred regimen because indinavir is no longer a preferred protease inhibitor. The protease inhibitor lopinavir-ritonavir is considered the preferred protease inhibitor.

    Answer C is incorrect. The use of abacavir plus tenofovir DF plus lamivudine as a three-drug regimen is an antiretroviral regimens that should not be offered at any time. This recommendation is based on several studies that showed an unacceptably high virologic failure rate with this regimen.


    Answer D is incorrect. The use of a regimen that contains zidovudine plus stavudine should not be offered at any time. This recommendation is based on data demonstrating antagonism between zidovudine and stavudine.

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