Sponsored Links
Results 1 to 3 of 3
  1. #1
    usmlemate is offline Junior Member
    Join Date
    Nov 2004
    Posts
    55
    Downloads
    0
    Uploads
    0
    Thanks
    0
    Thanked 0 Times in 0 Posts

    Laboratory Monitoring after Initiating Antiretroviral Therap

    Advertisements



    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 2004 DHHS antiretroviral guidelines, which of the following is TRUE regarding laboratory monitoring after starting this patient on antiretroviral therapy.

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

    B. A follow-up HIV RNA value should first be checked 10-12 weeks after starting therapy.

    C. A follow-up HIV RNA value should first be checked 2-8 weeks after starting therapy.

    D. If the patient had his 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.

  2. #2
    Asclepius1's Avatar
    Asclepius1 is offline Ultimate Member 537 points
    Join Date
    Feb 2006
    Posts
    5,087
    Downloads
    0
    Uploads
    0
    Thanks
    0
    Thanked 0 Times in 0 Posts
    D?

  3. #3
    usmlemate is offline Junior Member
    Join Date
    Nov 2004
    Posts
    55
    Downloads
    0
    Uploads
    0
    Thanks
    0
    Thanked 0 Times in 0 Posts

    Re: Laboratory Monitoring after Initiating Antiretroviral Therap

    Quote Originally Posted by usmlemate
    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 2004 DHHS antiretroviral guidelines, which of the following is TRUE regarding laboratory monitoring after starting this patient on antiretroviral therapy.

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

    B. A follow-up HIV RNA value should first be checked 10-12 weeks after starting therapy.

    C. A follow-up HIV RNA value should first be checked 2-8 weeks after starting therapy.

    D. If the patient had his 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.
    The correct answer is C. According to the 2004 DHHS guidelines, patients should have an HIV RNA value checked 2-8 weeks after antiretroviral therapy is started. The first post-treatment HIV RNA value should indicate a substantial decrease in the HIV RNA level (at least a 1.0 log decrease compared with baseline).


    Answer A is incorrect. Although monitoring CD4 cell count responses provides important information regarding the immunologic response to antiretroviral therapy, 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 8-12 weeks. The initial HIV RNA response provides the best early feedback regarding the patientís response to antiretroviral medications.


    Answer B is incorrect. According to the 2004 DHHS guidelines, patients should have an HIV RNA value checked 2-8 weeks after antiretroviral therapy is started. Waiting 10-12 weeks before checking an HIV RNA value could result in a missed opportunity to detect early inadequate virologic response that may have occurred as a result of poor adherence, pre-existing drug resistance, or use of a regimen with inadequate potency.


    Answer D is incorrect. The first post-treatment HIV RNA values should indicate a substantial decrease in the HIV RNA level (at least a 1.0 log decrease compared with baseline).

Similar Threads

  1. Is the gov monitoring you? See link to find out!
    By citizenimg in forum The Relaxing Lounge
    Replies: 0
    Last Post: 04-01-2010, 10:06 AM
  2. Antiretroviral Therapy for Acute (Primary) HIV
    By usmlemate in forum Internal Medicine Forum
    Replies: 1
    Last Post: 12-06-2004, 07:45 AM
  3. Antiretroviral Regimens for Initial Therapy
    By usmlemate in forum Internal Medicine Forum
    Replies: 2
    Last Post: 12-01-2004, 03:07 PM
  4. Indications for Initiating Antiretroviral Therapy
    By usmlemate in forum Internal Medicine Forum
    Replies: 2
    Last Post: 12-01-2004, 03:04 PM
  5. Replies: 3
    Last Post: 08-16-2004, 08:03 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •