HIV/AIDS EXAM PRACTICE QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
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SECTION I: ANTIRETROVIRAL THERAPY PRINCIPLES & DRUG CLASSES
1. A 35-year-old patient is newly diagnosed with HIV. The patient asks, "What is
the goal of starting HIV medications?" What is the MOST accurate evidence-
based response?
• A) To cure the HIV infection completely
• B) To suppress the viral load to undetectable levels, restore immune
function, prevent disease progression, and eliminate sexual transmission
risk (U=U)
• C) To increase the CD4 count to >500 cells/mm³ and stop therapy
• D) To prevent opportunistic infections only
Correct Answer: B
*Rationale: The primary goal of ART is to durably suppress plasma HIV-1 RNA to
undetectable levels, which restores and preserves immune function, reduces HIV-
associated morbidity and mortality, and prevents sexual transmission (U=U). ART
is not curative, as HIV establishes latent reservoirs .*
2. A 40-year-old patient with HIV is started on a combination ART regimen.
According to the NIH guidelines, when should ART be initiated in a patient with
early (acute or recent) HIV infection?
• A) After confirming a CD4 count <200 cells/mm³
, • B) After receiving genotypic resistance test results
• C) As soon as possible; ART initiation should not be delayed while awaiting
resistance testing results
• D) After completing treatment for all opportunistic infections
Correct Answer: C
Rationale: In patients with early HIV infection, ART should be initiated as soon as
possible due to immunologic benefits and reduced transmission risk. ART initiation
should not be delayed while awaiting resistance testing results; the regimen can
be modified once results are reported .
3. A 45-year-old patient with HIV is started on a regimen containing a nucleoside
reverse transcriptase inhibitor (NRTI). Which mechanism describes how NRTIs
work?
• A) They bind non-competitively to reverse transcriptase, inducing a
conformational change
• B) They competitively inhibit HIV reverse transcriptase and act as chain
terminators, interrupting HIV replication
• C) They bind the integrase enzyme active site, blocking strand transfer
• D) They prevent fusion of HIV to the CD4 cell membrane
Correct Answer: B
Rationale: NRTIs are analogs of native nucleosides that competitively inhibit HIV
reverse transcriptase and, once incorporated into the growing DNA chain, act as
chain terminators, interrupting HIV replication .
4. A 38-year-old patient with HIV is started on a non-nucleoside reverse
transcriptase inhibitor (NNRTI). Which statement correctly describes the
mechanism of NNRTIs?
, • A) They are chain terminators that compete with natural nucleosides
• B) They bind to the p66 subunit of reverse transcriptase, inducing a
conformational change that alters the active site and limits activity
• C) They bind to the integrase enzyme active site
• D) They block the CCR5 coreceptor
Correct Answer: B
*Rationale: NNRTIs bind non-competitively to the p66 subunit of HIV reverse
transcriptase, inducing a conformational change that alters the active site and
limits enzyme activity. HIV-2 is not susceptible to NNRTIs .*
5. A 50-year-old patient with HIV has virologic failure on an integrase strand
transfer inhibitor (INSTI)-containing regimen. What is the MOST appropriate
next step according to NIH guidelines?
• A) Switch to a two-drug regimen without resistance testing
• B) Perform genotypic resistance testing, including testing for integrase gene
mutations, while the patient is still taking the failing regimen
• C) Discontinue ART for 4 weeks before resistance testing
• D) Add a single new drug to the failing regimen
Correct Answer: B
*Rationale: For patients with virologic failure on an INSTI-based regimen,
genotypic resistance testing should be performed, including testing for integrase
gene mutations. Testing should be performed while the patient is still taking the
failing regimen or within 4 weeks of discontinuation to detect resistance
mutations .*
6. A 42-year-old patient with HIV is started on a protease inhibitor (PI)-based
regimen. What is the role of low-dose ritonavir (RTV) when used with other PIs?
CORRECT ANSWERS (VERIFIED ANSWERS) PLUS
RATIONALES 2026 Q&A | INSTANT DOWNLOAD
SECTION I: ANTIRETROVIRAL THERAPY PRINCIPLES & DRUG CLASSES
1. A 35-year-old patient is newly diagnosed with HIV. The patient asks, "What is
the goal of starting HIV medications?" What is the MOST accurate evidence-
based response?
• A) To cure the HIV infection completely
• B) To suppress the viral load to undetectable levels, restore immune
function, prevent disease progression, and eliminate sexual transmission
risk (U=U)
• C) To increase the CD4 count to >500 cells/mm³ and stop therapy
• D) To prevent opportunistic infections only
Correct Answer: B
*Rationale: The primary goal of ART is to durably suppress plasma HIV-1 RNA to
undetectable levels, which restores and preserves immune function, reduces HIV-
associated morbidity and mortality, and prevents sexual transmission (U=U). ART
is not curative, as HIV establishes latent reservoirs .*
2. A 40-year-old patient with HIV is started on a combination ART regimen.
According to the NIH guidelines, when should ART be initiated in a patient with
early (acute or recent) HIV infection?
• A) After confirming a CD4 count <200 cells/mm³
, • B) After receiving genotypic resistance test results
• C) As soon as possible; ART initiation should not be delayed while awaiting
resistance testing results
• D) After completing treatment for all opportunistic infections
Correct Answer: C
Rationale: In patients with early HIV infection, ART should be initiated as soon as
possible due to immunologic benefits and reduced transmission risk. ART initiation
should not be delayed while awaiting resistance testing results; the regimen can
be modified once results are reported .
3. A 45-year-old patient with HIV is started on a regimen containing a nucleoside
reverse transcriptase inhibitor (NRTI). Which mechanism describes how NRTIs
work?
• A) They bind non-competitively to reverse transcriptase, inducing a
conformational change
• B) They competitively inhibit HIV reverse transcriptase and act as chain
terminators, interrupting HIV replication
• C) They bind the integrase enzyme active site, blocking strand transfer
• D) They prevent fusion of HIV to the CD4 cell membrane
Correct Answer: B
Rationale: NRTIs are analogs of native nucleosides that competitively inhibit HIV
reverse transcriptase and, once incorporated into the growing DNA chain, act as
chain terminators, interrupting HIV replication .
4. A 38-year-old patient with HIV is started on a non-nucleoside reverse
transcriptase inhibitor (NNRTI). Which statement correctly describes the
mechanism of NNRTIs?
, • A) They are chain terminators that compete with natural nucleosides
• B) They bind to the p66 subunit of reverse transcriptase, inducing a
conformational change that alters the active site and limits activity
• C) They bind to the integrase enzyme active site
• D) They block the CCR5 coreceptor
Correct Answer: B
*Rationale: NNRTIs bind non-competitively to the p66 subunit of HIV reverse
transcriptase, inducing a conformational change that alters the active site and
limits enzyme activity. HIV-2 is not susceptible to NNRTIs .*
5. A 50-year-old patient with HIV has virologic failure on an integrase strand
transfer inhibitor (INSTI)-containing regimen. What is the MOST appropriate
next step according to NIH guidelines?
• A) Switch to a two-drug regimen without resistance testing
• B) Perform genotypic resistance testing, including testing for integrase gene
mutations, while the patient is still taking the failing regimen
• C) Discontinue ART for 4 weeks before resistance testing
• D) Add a single new drug to the failing regimen
Correct Answer: B
*Rationale: For patients with virologic failure on an INSTI-based regimen,
genotypic resistance testing should be performed, including testing for integrase
gene mutations. Testing should be performed while the patient is still taking the
failing regimen or within 4 weeks of discontinuation to detect resistance
mutations .*
6. A 42-year-old patient with HIV is started on a protease inhibitor (PI)-based
regimen. What is the role of low-dose ritonavir (RTV) when used with other PIs?
