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PORN — SCE Infectious Diseases MCQ

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HardHIV MedicinePORNSCE Infectious Diseases

Soon after ART initiation, a person with advanced HIV develops rapidly progressive painless visual loss and multifocal outer-retinal necrosis. Ocular fluid is positive for varicella-zoster virus. What is the diagnosis?

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Correct answer: E — VZV-associated progressive outer retinal necrosis with immune-recovery inflammation

The best answer is “VZV-associated progressive outer retinal necrosis with immune-recovery inflammation”. PORN is a fulminant VZV retinitis in profound cellular immunodeficiency; immune recovery can intensify inflammation, but urgent systemic and intravitreal antiviral therapy is required. BHIVA guidance governs investigation and treatment of HIV-associated disease and supports standard specialist care when HIV is virologically controlled.

Reference: BHIVA clinical guidelines: https://bhiva.org/clinical-guidelines/