WBR0559

Author	[[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Microbiology
Sub Category	SubCategory::Infectious Disease
Prompt	[[Prompt::A 44 year old man with history of multiple unprotected sexual encounters was found to have a positive HIV ELISA during a local screening campaign. He was referred to an HIV clinic where he was advised to monitor his CD4 counts once every month. A trend of his CD4 counts for past 10 months are shown below. At which of the following CD4 values would you advise the patient to receive azithromycin prophylaxis? ]]
Answer A	AnswerA::A
Answer A Explanation	AnswerAExp::
Answer B	AnswerB::B
Answer B Explanation	AnswerBExp::
Answer C	AnswerC::C
Answer C Explanation	AnswerCExp::
Answer D	AnswerD::D
Answer D Explanation	AnswerDExp::
Answer E	AnswerE::E
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::
Explanation	[[Explanation::Azithromycin is used in patients with HIV who progressed to AIDS with a CD4 count lower than 50 cells/mL for the prophylaxis for disseminated mycobacterium avium complex (MAC) infections. The added benefit of using azithromycin prophylaxis is the coverage for Toxoplasma gondii reactivation even though systematic prophylaxis for Toxoplasma below a CD4 of 100 is not recommended. The table below summarizes the AIDS associated illnesses and the corresponding CD4 counts at which they are observed. Educational Objective: References: ]]
Approved	Approved::No
Keyword
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