A 42-year-old man newly diagnosed with HIV has CD4 count 86/mm3 and HIV RNA 220,000 copies/mL. He has no respiratory symptoms. Toxoplasma IgG is

Question

A 42-year-old man newly diagnosed with HIV has CD4 count 86/mm3 and HIV RNA 220,000 copies/mL. He has no respiratory symptoms. Toxoplasma IgG is positive, and G6PD level is normal. Antiretroviral therapy is planned. Which of the following would you recommend?

Accepted Answer

Trimethoprim-sulfamethoxazole prophylaxis

Answer

No prophylaxis until CD4 count is below 50/mm3

Answer

Fluconazole prophylaxis

Answer

Isoniazid without tuberculosis testing

Answer

Azithromycin weekly as the sole opportunistic infection prophylaxis

HIV opportunistic infection prophylaxis — ABIM Board MCQ

A 42-year-old man newly diagnosed with HIV has CD4 count 86/mm3 and HIV RNA 220,000 copies/mL. He has no respiratory symptoms. Toxoplasma IgG is positive, and G6PD level is normal. Antiretroviral therapy is planned. Which of the following would you recommend?