A 31-year-old man is newly diagnosed with HIV infection. CD4 count is 42 cells/uL. He has no fever, cough or diarrhoea currently. Along with ART and cotrimoxazole prophylaxis, which additional prophylactic medication is indicated?
- A Daily acyclovir for cytomegalovirus disease
- B Monthly intravenous pentamidine for histoplasmosis
- C Weekly azithromycin for disseminated Mycobacterium avium complex ✓
- D Daily valganciclovir for JC virus infection
Correct answer: C. Weekly azithromycin for disseminated Mycobacterium avium complex
Explanation
Primary prophylaxis against disseminated MAC with azithromycin (1200 mg weekly) or clarithromycin is recommended once CD4 falls below 50 cells/uL, and can be stopped once ART raises CD4 above 100 cells/uL for 3 months. There is no established prophylaxis for CMV, histoplasmosis or progressive multifocal leukoencephalopathy; these are treated only after disease develops.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.