Question

Results ➢Tuberculin Test: positive ➢Blood antibody (serology) tests: Negative for everything but HIV ➢CD4 count: 40 (normal 800-1200)/ml ➢Viral load, HIV = 750,000 copies/ml ➢Based on this and his symptoms of coughing up blood he is sent for more tests. Bronchoscopy • Bronchoscope is wedged into the bronchus of the lobe in which disease is suspected by x-ray • 100-200 ml of saline injected, washes the alveoli • Fluid is aspirated and collected (BAL) • Very useful for viral agents and Pneumocystis jiroveci in addition to M. tuberculosis • Best way to adequately sample the lungs

What would you order from the lab before you decided on an antiHIV treatment?
A. CBC (complete blood count)
B. Liver enzymes
C. Genetic analysis of Mr. Kenta
D. Genetic analysis of the HIV from the blood

Answer 1

To select an appropriate antiHIV treatment, a genetic analysis of the HIV from the patient’s blood should be ordered to identify drug resistances and guide the choice of antiretroviral therapy.

Step-by-step explanation:

Before deciding on an antiHIV treatment for a patient with a positive Tuberculin Test, negative blood antibody tests (except for HIV), a CD4 count of 40/ml, and an HIV viral load of 750,000 copies/ml, it is imperative to perform additional laboratory tests to ensure a personalized and effective treatment strategy. Specifically, you should order a genetic analysis of the HIV from the patient's blood (Option D). This test will help identify the genotype of the HIV virus, which is crucial for determining potential drug resistances and selecting the most appropriate antiretroviral therapy. While a CBC and liver enzymes are important baseline tests, they do not provide information on the virus itself that would influence antiretroviral therapy selection. The mentioned genetic analysis informs the resistance profile of the virus and guides in the selection of a regimen that the virus is sensitive to, thus optimizing the patient's treatment outcome.