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Angel Desai, MD, MPH
Angel Desai, MD, MPH
University of California Davis Medical Center
Sacramento, CA
CROI
Conference on Bacteriophages
RWHAP CLINICAL CONFERENCE
Podcasts
Slides
Question of the Week
Donate
Contact
CME Courses
HIV In-Person and Virtual Courses
Current On-Demand Courses
About Courses
CME Webinars
Upcoming Webinars
Current On-Demand Webinars
MATE Act CME
About Webinars
Dialogues
Upcoming IAS–USA Dialogues: Emerging Infections and Health Threats
On-Demand Dialogues
About Dialogues
Topics In Antiviral Medicine
Current Issues for CME
Previous Issues
TAM
Policies and Practices
Permission Request Form
HIV Drug Resistance
HIV Drug Resistance Mutations Chart
Recent Webinars
Journal Articles
Fellow Resources
Resources for Fellows and Others New to the HIV Field
On-Demand Webinars for Fellows
IAS-USA Guidelines and Recommendations
On-Demand Webcasts
Research Collaborations
Additional Resources
About
Scientific Leadership Board
IAS-USA Leadership Award Recipients
Core Faculty
Mission
Staff
CME
Funding Information
Careers
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Discrimination and Harassment Policy
Governance
Suggestions and Recommendations from San Francisco Locals
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Practice Question of the Week
February 9, 2026: Antiretroviral Therapy Management in the Setting of HIV Drug Resistance
A person with long-standing HIV has extensive nucleoside reverse transcriptase inhibitor (nRTI) resistance, including several thymidine-associated mutations and the M184V mutation. He was on a regimen consisting of single-pill darunavir/cobicistat/emtricitabine (FTC)/tenofovir alafenamide (TAF) plus dolutegravir and was virologically suppressed. He then switched to bictegravir/TAF/FTC and maintained virologic suppression. Which of the following principles best explains why viral suppression can often be maintained in this setting?
A. Archived nRTI resistance mutations are rarely clinically relevant
B. TAF fully overcomes thymidine-associated mutations
C. Second-generation integrase strand transfer inhibitors (InSTIs) have a high barrier to resistance and can maintain suppression despite compromised nRTI activity
D. FTC restores susceptibility when combined with InSTIs
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