Final answer:
The preferred treatment for MAC in HIV-positive patients is antibiotic therapy when the patient's CD4 count is below 50 cells/mm^3. Antiretroviral therapy is also critical to control HIV and prevent opportunistic infections. Monitoring CD4 T-cell count guides treatment and prophylaxis decisions. The correct answer is b. Antibiotic therapy; when CD4 count is above 200 cells/mm^3.
Step-by-step explanation:
The preferred treatment for Mycobacterium avium complex (MAC) infection in HIV-positive patients is antibiotic therapy; specifically, a combination of antimicrobial drugs, while the indication for treatment is typically when a patient's CD4 count falls below 50 cells/mm3.
Starting antiretroviral therapy (ART) to control HIV is crucial, and can inherently improve immune function and reduce the risk of opportunistic infections like MAC.
ART is designed to keep viral loads low, prevent disease progression to AIDS (defined by a CD4 count of less than 200 cells/mm3 or the presence of certain opportunistic infections), and increase life expectancy. It should be initiated as soon as HIV is diagnosed and taken consistently.
It is also important to monitor CD4 T-cell counts, as this helps guide treatment decisions. In cases without active MAC infection but with CD4 counts below 50 cells/mm3, prophylaxis with antibiotics may be recommended to prevent MAC occurrence.
With effective ART and timely antibiotics, HIV infection has been transformed from a fatal disease to a chronic condition that can be managed.