input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 10-year-old girl is brought to a clinic by her parents after 1 week of difficulty breathing, dry cough, and low-grade fevers. She has also developed shallow erythematous ulcers inside of her mouth. There is no history of chills, rigors, or headaches. Her appetite has decreased. The girl has been HIV-positive since birth and is being treated with HAART. Her baseline viral load is <50/mL. On general examination, the girl appears ill. Diffuse inspiratory crackles are heard on chest auscultation with normal heart sounds. No lymphadenopathy or hepatosplenomegaly is noted on physical examination. A blood sample is drawn, which shows a CD4 count of 100/mm3 and a viral load of 25,050/mL. What is the most likely mechanism responsible for the lack of responsiveness to therapy?   (A) Ineffective CD8 cytotoxicity   (B) env gene mutation   (C) pol gene mutation   (D) Decreased viral replication
output: ['(C) pol gene mutation <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Ineffective CD8 cytotoxicity  (B) env gene mutation  (C) pol gene mutation  (D) Decreased viral replication <> possible answers', '  A 10-year-old girl is brought to a clinic by her parents after 1 week of difficulty breathing, dry cough, and low-grade fevers. She has also developed shallow erythematous ulcers inside of her mouth. There is no history of chills, rigors, or headaches. Her appetite has decreased. The girl has been HIV-positive since birth and is being treated with HAART. Her baseline viral load is <50/mL. On general examination, the girl appears ill. Diffuse inspiratory crackles are heard on chest auscultation with normal heart sounds. No lymphadenopathy or hepatosplenomegaly is noted on physical examination. A blood sample is drawn, which shows a CD4 count of 100/mm3 and a viral load of 25,050/mL. What is the most likely mechanism responsible for the lack of responsiveness to therapy? <> context']