A 40-year-old patient infected with human immunodeficiency virus (HIV) asks the nurse why the new drug maraviroc (Selzentry) is not being prescribed for her. What is the nurse's best re-sponse?
a. "This drug is very expensive and your insurance may not cover it."
b. "This drug can cause birth defects and should not be prescribed for anyone who is pregnant or might become pregnant."
c. "This drug is very toxic to the heart and lungs. It is prescribed only for patients who are young and have no other health problems."
d. "This drug is not effective against all HIV subtypes and the HIV causing your infection does not have the target for this drug."
D
Maraviroc prevents cellular infection by blocking the CCR5 receptor on CD4+ T-cells. Because this drug is not effective against all HIV subtypes, the patient must first be tested to ensure that his or her HIV infection is likely to respond to this therapy. When the HIV subtype does not use the CCR5 receptor, the drug is not prescribed for that patient.
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