HIV-2: antiretroviral susceptibility: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · HIV-2: antiretroviral susceptibility

Sample item

Serology confirms HIV-2 mono-infection in an adult from Goa who needs antiretroviral therapy. Which agent should be avoided because HIV-2 is intrinsically resistant?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Efavirenz

HIV-2 is intrinsically resistant to non-nucleoside reverse transcriptase inhibitors such as efavirenz and nevirapine, and to enfuvirtide. Nucleoside analogues, integrase inhibitors and many protease inhibitors remain active. Therefore, a regimen is built on dolutegravir or a boosted protease inhibitor.

Option by option

  • A. Tenofovir

    Tenofovir is a nucleotide analogue with activity against HIV-2.

  • B. Efavirenz (correct)

    Correct. NNRTIs do not work against HIV-2.

  • C. Lopinavir with ritonavir

    Lopinavir-ritonavir remains active against HIV-2.

  • D. Dolutegravir

    Dolutegravir is an integrase inhibitor that is active against HIV-2.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is B, Efavirenz. HIV-2 is intrinsically resistant to non-nucleoside reverse transcriptase inhibitors such as efavirenz and nevirapine, and to enfuvirtide.

Why is "Tenofovir" not the answer?

Tenofovir is a nucleotide analogue with activity against HIV-2.

Why is "Lopinavir with ritonavir" not the answer?

Lopinavir-ritonavir remains active against HIV-2.

Why is "Dolutegravir" not the answer?

Dolutegravir is an integrase inhibitor that is active against HIV-2.

What concept does this question test?

It tests HIV-2: antiretroviral susceptibility in Microbiology. Nucleoside analogues, integrase inhibitors and many protease inhibitors remain active. Therefore, a regimen is built on dolutegravir or a boosted protease inhibitor.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study HIV-2: antiretroviral susceptibility?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.