[khanar]

A 32 year old HIV positive woman has been doing well on a combination of Didanosine, Lamivudine, and Efavirenz. She's visiting her physician because she missed her menstrual period 6 weeks ago.
Lab results showed the following:
Pregnancy Test: Positive
Total WBC count: 7500/uL (60% neutrophils, 25% lymphocytes)
Hb: 11.2 g/dL
ALT: 20 IU/, AST: 12 IU/l, Lipase 1200 U/l
PCR-RNA: 65
CD4: 420/uL

Which of the following is most appropriate regarding her Highly Active Antiretroviral Therapy (HAART)?
A- Change regimen to Emtricitabine, Tenofovir, and Efavirenz.
B- Change regimen to Emtricitabine, Tenofovir, and Atazanvir.
C- Change regimen to Didanosine, Lamivudine, and Ritonavir.
D- Change regimen to Didanosine, Zidovudine, and Efavirenz.
E- No change is needed

 

[NeuroSinapsis]

Hi, kind of tricky question. I know for a fact that in all pregnant patients at least zidovudine (AZT) must be present, so my choice will be D.

 

[khanar]

Hi, kind of tricky question. I know for a fact that in all pregnant patients at least zidovudine (AZT) must be present, so my choice will be D.

I was thinking like you but the problem is that this patient is having pancreatitis (high lipase) and we should not give her Didanosine I guess

 

[abhinav]

efavirenz being contraindicated in pregnancy and didanosine causing pancreatitis
option B seems to be d correct one...

 

[khanar]

efavirenz being contraindicated in pregnancy and didanosine causing pancreatitis
option B seems to be d correct one...

Oh yeah, I think you are right