American Board of Internal Medicine (ABIM) Certification Practice Exam

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Patients with HIV/AIDS and CD4 counts less than what level should undergo prophylaxis against Mycobacterium avium complex?

  1. 100/µL

  2. 200/µL

  3. 50/µL

  4. 300/µL

The correct answer is: 50/µL

Patients with HIV/AIDS who have a CD4 count less than 50 cells/µL are at increased risk for opportunistic infections, including Mycobacterium avium complex (MAC). The guidelines recommend initiating prophylaxis with azithromycin or clarithromycin to prevent the onset of MAC disease when CD4 counts fall below this critical threshold. This prophylactic measure is essential because once a patient is diagnosed with MAC, treatment can be complicated and the disease can significantly impact their health. Monitoring CD4 counts in patients with HIV is crucial; as they decline, the risks for various opportunistic infections, including MAC, increase. Therefore, starting prophylaxis at a CD4 level of less than 50 cells/µL is a well-established practice in managing and preventing serious infections in immunocompromised patients.

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