A 42-year-old woman newly diagnosed with HIV (CD4 425, HIV RNA 73,000, genotype with wild-type virus) starts tenofovir alafenamide/emtricitabine/bictegravir and has the following virologic response:

Weeks of Therapy HIV Viral Load

4 weeks HIV RNA 9,400

8 weeks HIV RNA 1,050

16 weeks HIV RNA 105

24 weeks HIV RNA 90

36 weeks HIV RNA 67

48 weeks HIV RNA 82

In addition to reinforcing adherence, what would you recommend?


A. Add darunavir/ritonavir

B. Add etravirine

C. Add darunavir/ritonavir and etravirine

D. Switch bictegravir to darunavir/ritonavir

E. Continue current regimen


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