asymptomatic AIDS - fishoil

[ArchivalUser]

A 36-year-old woman is asymptomatic and has a CD4 cell count of 210/mm3 and a baseline viral load of >750,000 copies/mL. Other laboratory studies are unremarkable. She seeks your advice regarding management.
Question: What can you recommend?
a. zidovudine (AZT) plus stavudine (d4T) plus efavirenz (EFV)
b. lamivudine (3TC) plus zidovudine plus nelfinavir (NFV)
c. Trizivir (AZT + 3TC + ABC) plus lopinavir/ritonavir (LPV/r)
d. Trizivir
e. lamivudine plus stavudine plus indinavir (IDV)

[ArchivalUser]

treat the guy normally with 2NRTIs and 1 proteases inhibitor
bbb best choice

[ArchivalUser]

B is not the right answer
anybody ?

[ArchivalUser]

Answer:
Virtually all of these are feasible except option a, which combines zidovudine and stavudine, a combination that shows pharmacologic antagonism. The worrisome part of her presentation is that the CD4 cell count is quite low and approaching the threshold of vulnerability to opportunistic infections, and the viral load is very high, which poses substantial challenge to virologic control. The best drugs for baseline high viral load according to currently available data are 2 nucleosides combined with efavirenz or lopinavir/ritonavir. Thus, option c would be the best choice.

[ArchivalUser]

c is the answer,I am dead sure!!!!!!!!!!!!!!!!!!!!!!

[ArchivalUser]

still don't get it

[ArchivalUser]

actually me too got confused with these...i am chossing between b and c...but the Q i got from CDC, that was thier explanation.

[ArchivalUser]

b. lamivudine (3TC) plus zidovudine plus nelfinavir (NFV)

[ArchivalUser]

fishoil
how about choice e why is it incorrect?

[ArchivalUser]

cant tell you guys i just got this Q from other website, and they gave that explanation. probably wasp can explain coz he/she is sure.