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A 50-year-old man with long-standing HIV infection was admitted to the hospital with gallstone-related pancreatitis. Despite extensive prior treatment with multiple agents in all three major drug classes, he had maintained clinical stability on a regimen of tenofovir/FTC and ritonavir-boosted fosamprenavir for the previous 3 years, with his CD4 count stable at 300 to 500 cells/mm3 and his viral load measuring either <50 copies/mL or 50 to 500 copies/mL. At this level of viremia, no resistance test had been performed. In the days preceding his admission and during much of his hospital stay, however, the man was unable to take anything by mouth, including his antiretrovirals. His viral load rebounded to 15,000 copies/mL, and a genotypic resis…