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HIV initial ART — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)HIV initial ARTUSMLE Step 3

A 33-year-old man is newly diagnosed with HIV. Viral load is 84,000 copies/mL and CD4 count is 420/mm3. He has no opportunistic infection symptoms, creatinine is normal, and HLA-B*5701 is pending. He is ready to start treatment. Which of the following is the most appropriate next step in management?

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Correct answer: A — Start an integrase inhibitor-based antiretroviral regimen

Antiretroviral therapy is recommended for HIV regardless of CD4 count; integrase inhibitor-based combinations are preferred initial regimens for most patients.

Reference: DHHS Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV