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A 27-year-old man with HIV presents to your clinic to establish care. He believes he acquired his infection from a blood transfusion he received in sub-Saharan Africa while serving in the Peace Corps 3 years ago. He is currently asymptomatic and has a strong social support network. His examination is unremarkable. During the clinic visit, he asks about starting medical therapy for his HIV. His CD4+ T cell count is 450/mm3, and his HIV RNA level is 20,000 copies/ml.
Which of the following is an indication to initiate HAART?
1. CD4+ T cell count of less than 500/mm3
2. HIV RNA level of 50,000 copies/ml and a normal CD4+ T cell count
3. Oral thrush
4. HIV RNA level of 75,000 copies/ml and CD4+ T cell percentage of 28%
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Hi i dont know the ans of this q and its confusing.......can ne1 help....
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ok found this
The treatment guidelines specifically for the USA are set by the United States Department of Health and Human Services (DHHS). The current guidelines for adults and adolescents were stated on October 6, 2005 [9]:
* All patients with history of an AIDS-defining illness or severe symptoms of HIV infection regardless of CD4+ T cell count receive ART.
* Antiretroviral therapy is also recommended for asymptomatic patients with less than 200 CD4+ T cells/µl.
* Asymptomatic patients with CD4+ T cell counts of 201“350 cells/µl should be offered treatment.
* For asymptomatic patients with CD4+ T cell of greater than 350 cells/µl and plasma HIV RNA greater than 100,000 copies/ml, most experienced clinicians defer therapy but some clinicians may consider initiating treatment.
* Therapy should be deferred for patients with CD4+ T cell counts of greater than 350 cells/µl and plasma HIV RNA less than 100,000 copies/mL.
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ther are 2 indications for starting HAART ..... (i am sure you know those)...even if one is present...start HAART........
but for revision....
1. CD4 count less tha 350
2. RNA copies of 50, 000 and greater!
i really do not know the exact number of CD4 T cells...only than i can calculate the percentage!
I would choose..... 2 ....if i had to....makes sense tome!
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yes but reading these guidelines dont u think 4 is the ans ( i myself went for 2 in the beginning)
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on 2nd though the answer should be..3...oral thrush..pt's usually get thrush when CD4 counts is aorund 200....
i would most definitely choose...3.... final answer!
