01-02-2008, 09:33 AM
Infectious Disease Medicine:Question 2
A 35-year-old man was found to be HIV positive when he applied for life insurance. He is not certain when he became infected, but this could have occurred as long as 10 years ago. The patients only symptom is occasional night sweats two to three times each month. He otherwise feels well, works full time, and has never been hospitalized.
Physical examination discloses small white exudative patches on his soft palate that are consistent with thrush. His CD4 cell count is 260/μL, and his plasma HIV RNA viral load is 1550 copies/mL.
Which of the following is the most appropriate management for this patient?
A. Repeat the CD4 cell count; begin antiretroviral therapy only if the count is below 200/μL
B. Repeat the plasma HIV RNA determination; begin antiretroviral therapy only if the viral load is greater than 10,000 copies/mL
C. Antiretroviral therapy is not indicated at this time because the patient is asymptomatic
D. Begin treatment now with a three-drug antiretroviral regimen
E. Begin treatment now with a two-drug antiretroviral regimen
A 35-year-old man was found to be HIV positive when he applied for life insurance. He is not certain when he became infected, but this could have occurred as long as 10 years ago. The patients only symptom is occasional night sweats two to three times each month. He otherwise feels well, works full time, and has never been hospitalized.
Physical examination discloses small white exudative patches on his soft palate that are consistent with thrush. His CD4 cell count is 260/μL, and his plasma HIV RNA viral load is 1550 copies/mL.
Which of the following is the most appropriate management for this patient?
A. Repeat the CD4 cell count; begin antiretroviral therapy only if the count is below 200/μL
B. Repeat the plasma HIV RNA determination; begin antiretroviral therapy only if the viral load is greater than 10,000 copies/mL
C. Antiretroviral therapy is not indicated at this time because the patient is asymptomatic
D. Begin treatment now with a three-drug antiretroviral regimen
E. Begin treatment now with a two-drug antiretroviral regimen