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A 45-year-old man with long-standing HIV infection was referred for a second opinion about antiretroviral therapy options. For the previous 5 years, he had been taking abacavir, 3TC, and lopinavir/ritonavir. Despite viral loads between 200 and 1000 copies/mL, he had remained clinically stable, with a CD4 count of 500 to 600 cells/mm3. Before starting this regimen, he had a resistance test that demonstrated NRTI, NNRTI, and PI resistance. On several occasions since then, his viral load has been too low to allow for additional resistance testing. Most recently, however, his viral load increased to 1100 copies/mL, and a specimen was sent for phenotype, genotype, and tropism testing. The following results returned.
NRTI genotype: 41L, 67N, 210W,…