A 55-year-old cisgender woman was recently diagnosed with HIV, with an initial CD4 count of 349 cells/mm3 and an HIV RNA level of 158,780 copies/mL. She is now being seen in clinic 4 weeks later and the plan is to start antiretroviral therapy. There is no evidence of resistance on the baseline genotype resistance assay. You are considering using either tenofovir DF-emtricitabine, tenofovir alafenamide-emtricitabine, or abacavir-lamivudine as the nucleoside reverse transcriptase inhibitor (NRTI) backbone, in combination with a third anchor drug. Which one of the following is TRUE regarding the NRTI backbone options for this patient as part of the initial antiretroviral therapy regimen? Abacavir-lamivudine gives better rates of virologic suppression than tenofovir DF-emtricitabine, regardless of the baseline HIV RNA or the anchor drug used in the regimen Abacavir requires baseline HLA-B*5701 screening and abacavir should not be used in persons with a positive test Tenofovir alafenamide is more likely than tenofovir DF to cause bone mineral density problems Baseline testing for fractional excretion of phosphorus is recommended prior to using tenofovir DF or tenofovir alafenamide
