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For the past couple of weeks, readers and our expert respondents have been discussing whether they would recommend a treatment change for one of my HIV-infected patients who was experiencing adverse effects on a cumbersome but otherwise successful antiretroviral regimen. The patient was new to my practice, and his prior medical records, including his previous resistance test results, were not available.
Like our expert respondents, I was ready to put this patient on tenofovir/FTC + ritonavir-boosted darunavir + raltegravir, but then someone I work with pointed out that a large commercial laboratory had consolidated many of the independent labs in the patient's city of origin. With the patient's permission, I contacted the lab, and the staff …