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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