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Review Question - QID 106845

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QID 106845 (Type "106845" in App Search)
A 25-year-old sexually active male presents to an internal medicine physician for a routine health check up after having several unprotected sexual encounters. After appropriate testing the physician discusses with the patient that he is HIV+ and must be started on anti-retroviral treatment. Which of the following medications prescribed acts on the gp41 subunit of the HIV envelope glycoprotein?

Amantadine

2%

11/440

Rimantadine

2%

9/440

Zidovudine

13%

59/440

Saquinavir

5%

24/440

Enfuvirtide

74%

327/440

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The medication that acts on the gp41 subunit of the HIV envelope glycoprotein is enfuvirtide.

Maraviroc and enfuvirtide are antiviral, fusion inhibitors that block viral attachment, penetration, or uncoating. Maraviroc functions by blocking the CCR5 protein on the T-cell surface thus inhibiting the entry of virus into T-cells. In contrast, enfuvirtide binds to the gp41 subunit of the HIV envelope glycoprotein preventing a conformational change (remember ENfuvirtide and ENvelope). This inhibits the fusion of the virus to T cells. Resistance arises to these medications via mutations in the env gene.

Incorrect Answers:
Answer 1-2: Amantadine and rimantadine binds to the M2 protein in influneza A thus preventing viral uncoating.
Answer 3: Zidovudine is a reverse transcriptase inhibitor.
Answer 4: Saquinavir is a protease inhibitor.

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