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When collecting data for an HIV-positive patient in the community pharmacy setting, which of the following has no direct influence on the antiretroviral therapy and prophylaxis chosen for your patient?
- Viral load
- CD4 lymphocyte count
- Co-infection with hepatitis C virus
- Renal function
- Screening for the HLA-B * 5701 allele
For a patient with a CD4 lymphocyte count of 120 cells/μL, prophylaxis for which types of infections is recommended?
- No prophylaxis
- Only toxoplasmosis
- Toxoplasmosis and Pneumocystis jirovecii pneumonia
- Only Pneumocystis jirovecii pneumonia
- Disseminated mycobacterium avium complex infection, toxoplasmosis and Pneumocystis jirovecii pneumonia
For a patient whose HLA-B * 5701 allele test is negative and who has risk factors for renal insufficiency, which associations of nucleoside reverse transcriptase inhibitors do you recommend?
- Abacavir-lamivudine or tenofovir alafenamide-emtricitabine
- Abacavir-emtricitabine or tenofovir alafenamide-lamivudine
- Abacavir-lamivudine only
- All combinations can be recommended
- Tenofovir disoproxyl fumarate-lamivudine or abacavir-emtricitabine
You have a patient who is struggling with significant dyspepsia and acid reflux. As a result, they take a proton pump inhibitor and antacids on a regular basis. Which of the following are antiretroviral options that will not require the management of interactions with these drugs?
- Raltegravir, etravirine or darunavir / ritonavir
- None of these choices
- Rilpivirine, raltegravir, dolutegravir or elvitegravir / cobicistat
- Etravirine or darunavir / ritonavir
For a patient who has been prescribed darunavir / ritonavir, which of the following advice is INAPPROPRIATE?
- If these medications give you gastrointestinal side effects, separate the intake of ritonavir and darunavir by taking them during two separate meals.
- Take these medications with food to reduce the risk of gastrointestinal adverse effects and to improve the absorption of darunavir.
- Some over-the-counter inhaled medications may interact with your medications. Always consult your pharmacist before using any of these products.
- Your history of sulphonamide allergy is not a contraindication to taking darunavir.
- If you become pregnant, you can continue the treatment since it is considered a suitable option during pregnancy.
You notice that a patient is not taking their antiretroviral therapy adequately since it has been at least 10% delayed at each refill for the past 5 months. Among the following, which DOES NOT designate a tool at your disposal that can be used to optimize your patient’s compliance:
- Motivational interviewing
- Interruption of treatment aiming to reduce the risk of resistance
- Non-prescription drugs to relieve adverse effects
- Referral to a multidisciplinary team
- Partial refills
A patient who discontinues their antiretroviral treatment exposes themselves to various consequences. Which of the following choices is NOT a potential consequence of treatment interruption?
- Deterioration of immune status
- Transmission of the virus to sexual partners
- Resistance to drugs with a high genetic barrier
- Exacerbation of hepatitis B
- Development of cancer