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Toxoplasmosis prophylaxis — DTM&H MCQ

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ModerateHIV/AIDS in tropical settingsToxoplasmosis prophylaxisDTM&H

A man with HIV has CD4 count 68 cells/mm³ and positive Toxoplasma IgG. He has not yet started prophylaxis and lives in a region with limited imaging access. What is the most appropriate prophylaxis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Co-trimoxazole prophylaxis

Co-trimoxazole prophylaxis is the single best answer because co-trimoxazole provides prophylaxis against toxoplasmosis as well as Pneumocystis in susceptible patients. Albendazole prophylaxis is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that seropositive patients with low CD4 counts are at risk of reactivation disease.

Reference: WHO consolidated HIV guidelines; WHO advanced HIV disease guidance; Manson's Tropical Diseases