K.E. is a 29-year-old asymptomatic patient who is human immunodefiiency virus (HIV) positive. She
recently found out she is pregnant and is estimatedto be early in her fist trimester. Her most recent
CD4 count was 170/mm3, and her viral load was 100,000 copies/mL by reverse transcriptase–polymerase chain reaction. Which is the best therapy forK.E. to prevent HIV transmission to her child?

R.E. is a 33-year-old man who has been HIV positive since 2005. Recently, his CD4 counts started to
decrease signifiantly, and his viral load started to increase. He is initiated on tenofovir, emtricitabine,and atazanavir/ritonavir. Which is the best counseling for R.E.?

3. One year later, R.E. is concerned that his antiretroviral therapy (ART) is not working and asks whether he should make some changes. Which statement best represents what to tell him?

.P.P., a 43-year-old man who is HIV positive, presents to the clinic with a headache that has gradually worsened during the past 2 weeks. He does not feel very sick and has not experienced any focal seizures. His most recent CD4 count was His laboratory profie is performed with the follow ing results: Gram stain = negative; white blood cell count = 2 cells/mm3; protein = 35 mg/dL; glucose = 75 mg/dL (peripheral = 110 mg/dL); India ink =positive; and cryptococcal antigen = 1:1024. Which is the best therapy for P.P.?

.A 57-year-old man presents with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) with a CD4 count of 75 cells/microliter at diagnosis and a viral load of 89,000 copies/mL. He has no other significant medical history and has an allergy to sulfa medications with hive reaction. Pertinent laboratory values are as follows:
Glucose-6-phosphate dehydrogenase positive Which medication would be best to initiate in the patient for prophylaxis
against Pneumocystis jirovecii?

. J.C., a 36-year-old woman positive for HIV, has severe anemia. She has been tested for iron defiiency and has been taken off zidovudine and trimethoprim/sulfamethoxazole. She has also started to lose weight and to have severe diarrhea. A blood culture is positive for MAC. Which treatment is best for J.C.?

. C.C. is a 30-year-old health care worker who is stuck by a needle that was being used to perform a venipuncture in a known HIV-seropositive patient. Which is the most important determinant with
respect to the effiacy of postexposure prophylaxis (PEP)?

. L.L. is a 42-year-old woman who underwent an allogeneic stem cell transplant for acute leukemia. Her
initial posttransplant course was uncomplicated;however, 1 month after engraftment (7 weeks posttransplant), the patient developed a fever and rash.A skin biopsy revealed graft-vs.-host disease, forwhich the patient’s tacrolimus dose was increased.L.L. also received high-dose steroids, which caused her fever to resolve and rash to improve. She was maintained on prednisone 30 mg orally once daily.One month later, L.L. presents to the hematology clinic with a worsening dry cough, shortness of breath, fever, and one episode of hemoptysis. Chest CT reveals a left-sided cavitary lesion. The hematologist would like to initiate antiAspergillus
therapy.
Which agent would be best to recommend?

The viral load relates to

L. L. comes to the clinic with a chief complaint of burning and tingling in his feet that started about 1 month ago. His current medications include nelfinavir, stavudine, lamivudine, sertraline, and gemfibrozil. Which medication might be causing this problem?