Disseminated Mycobacterium avium complex infection in an adult with HIV becomes a significant risk below which CD4 count, for which clarithromycin or azithromycin prophylaxis is recommended?

• A Below 350 cells/μL
• B Below 200 cells/μL
• C Below 100 cells/μL
• D Below 50 cells/μL ✓

Explanation

MAC bacteraemia and disseminated disease occur almost exclusively when the CD4 count is under 50 cells/μL, so macrolide prophylaxis is started at that threshold after ruling out active MAC by clinical assessment and blood cultures if indicated. The 200 cells/μL threshold applies to Pneumocystis prophylaxis, and 350 cells/μL has no prophylaxis indication in current practice.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.