HIV infection: The Daily PANCE Blueprint

A 42-year-old woman with newly diagnosed HIV presents for follow-up after her initial lab results. She has never been diagnosed with a sexually transmitted infection before and has no significant past medical history. Physical examination is unremarkable. Lab testing reveals a viral load of 300,000 copies/mL and a CD4 count of 180 cells/mm³. The patient has started antiretroviral therapy, and the physician assistant recommends an additional medication to prevent opportunistic infections based on her CD4 count. For which of the following pathogens is this prophylaxis most likely being prescribed?

A. Candida albicans
B. Cryptococcus neoformans
C. Mycobacterium avium-intracellulare
D. Pneumocystis jirovecii
E. Toxoplasma gondii

Answer and topic summary

The answer is D. Pneumocystis jirovecii

Patients with HIV and a CD4 count of <200 cells/mm³ are at high risk for Pneumocystis jirovecii pneumonia (PCP). Antimicrobial prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) is recommended as the first-line agent to prevent PCP in these patients. PCP prophylaxis should be initiated in all HIV patients with a CD4 count below 200 cells/mm³, as it is a leading cause of morbidity and mortality in this population.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ Viral Infectious Disease ⇒ HIV infection

 

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