Author Question: The nurse states that the development of an HIV vaccination has been unsuccessful due to the large ... (Read 18 times)

pane00 · **on:** Jul 23, 2018

The nurse states that the development of an HIV vaccination has been unsuccessful due to the large size of the HIV genome, which has ______ base pairs and leads to the high mutation rate of the virus.

Standard Text: Record your answer rounding to the nearest whole number.
Fill in the blank with the appropriate word.

Question 2

The nurse is asked by a client which drug regimens have been shown to be the most successful for the initial therapy of HIV infection. The nurse responds:

Standard Text: Select all that apply.
1. An NNRTI-based regimen.
2. PI-based regimens.
3. An integrase inhibitor-based regimen.
4. NRTIs/NtRTIs-based regimens.
5. Entry inhibitor-based regimens.

nhea · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 10,000
Rationale : It is estimated that, given the size of the HIV genome at 10,000 base pairs, every possible mutation probably occurs at every nucleotide daily in an untreated client. These errors create huge numbers of genetic variants, or mutant strains, with new and different characteristics from the original. It is not unusual to find dozens of genetic variants of HIV replicating within the same client. Thus, vaccine development, and indeed antiretroviral therapy, is trying to hit a moving target that is changing its genetic makeup literally every minute.
Global Rationale: It is estimated that, given the size of the HIV genome at 10,000 base pairs, every possible mutation probably occurs at every nucleotide daily in an untreated client. These errors create huge numbers of genetic variants, or mutant strains, with new and different characteristics from the original. It is not unusual to find dozens of genetic variants of HIV replicating within the same client. Thus, vaccine development, and indeed antiretroviral therapy, is trying to hit a moving target that is changing its genetic makeup literally every minute.

Answer to Question 2

Correct Answer: 1,2,3
Rationale 1: An NNRTI-based regimen of efavirenz + tenofovir + emtricitabine has been shown to be a successful choice for the initial therapy of HIV infection.
Rationale 2: A PI-based regimen of atazanavir (ritonavir-boosted) + tenofovir + emtricitabine or darunavir (ritonavir-boosted) + tenofovir + emtricitabine has been shown to be successful choices for the initial therapy of HIV infection.
Rationale 3: An integrase inhibitor-based regimen of raltegravir + tenofovir + emtricitabin has been shown to be a successful choice for the initial therapy of HIV infection.
Rationale 4: This regimen has not been proven to be successful for the initial treatment of HIV infection.
Rationale 5: This regimen has not been proven to be successful for the initial treatment of HIV infection.
Global Rationale: In current clinical practice, NNRTI-based regimens, PI based regimens, and Integrase inhibitor-based regimens have been shown to be the most successful choices for the initial therapy of HIV infection.