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Case 1: Indications for Initiating Antiretroviral Therapy

You answered:

B Defer antiretroviral therapy until the patient's CD4 count decreases to less than 500 cells/mm3

This answer is incorrect. The March 2012 DHHS antiretroviral therapy guidelines recommend initiating antiretroviral therapy for all HIV-infected patients regardless of clinical symptoms. It is reasonable to defer starting therapy until the CD4 count decreases to less than 500 cells/mm3 in certain circumstances, such as when significant barriers to adherence exist, comorbities (major surgery or drug-drug interactions) may complicate therapy, or with long-term non-progressors or elite controllers. The patient presented here had no reason to defer therapy and he also had an indication to initiate antiretroviral therapy based on his ongoing risk of transmitting HIV to his sexual partners.

Choose another answer:

A Initiate antiretroviral therapy.
C Defer antiretroviral therapy until the patient's CD4 count decreases to less than 350 cells/mm3.
D Defer antiretroviral therapy until the patient's CD4 count decreases to less than 200 cells/mm3 or the patient develops HIV-related clinical symptoms.

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