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Case 1: Indications for Initiating Antiretroviral Therapy

You answered:

A Initiate antiretroviral therapy.

This answer is correct. The March 2012 HHS Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents state that antiretroviral therapy is recommended for all HIV-infected individuals. The strength of this recommendation depends on the patient's CD4 cell count, with a strong recommendation to initiate therapy for a CD4 count less than or equal to 500 cells/mm3 and a moderate recommendation to initiate therapy for a CD4 count greater than 500 cells/mm3. The guidelines also strongly recommend initiating therapy, regardless of CD4 cell count, in the following four circumstances: pregnancy, history of AIDS-defining illness, HIV-associated nephropathy, and co-infection with hepatitis B virus. Based on data that show antiretroviral therapy can dramatically decrease the risk of HIV transmission to sexual partners, the guidelines also strongly recommend offering therapy to patients at risk of transmitting HIV to sexual partners.


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