HIV Vaccinations & Prophylaxis

A 35-year-old male plans to travel abroad from Pakistan. Different vaccinations were advised. He was diagnosed with HIV 5 years ago and was taking anti-retroviral therapy and co-trimoxazole prophylaxis. Which of the following vaccines can be given to him?

A 28-year-old male presented to the clinic requesting advice on preventing HIV infection. He reports being sexually active with multiple male partners and inconsistently using condoms. He had occasional encounters with partners of unknown HIV status. His recent HIV status is negative, and also tested negative for other sexually transmitted infections. What is the most appropriate intervention to reduce the risk of acquiring HIV infection?

A 40-year-old male came for follow-up of HIV. He stopped taking anti-retroviral therapy and started on antiretroviral therapy for 2 months. His recent workup showed a CD-4 count of 45 cells/mm³. What chemoprophylaxis should be given?

A 29-year-old nurse accidentally sustains a needle stick injury while drawing blood from a known HIV-positive patient in the emergency department. The patient’s most recent viral load is 50 copies/mL, and they are on antiretroviral therapy (ART) with good adherence. The nurse immediately washes the puncture site with soap and water and reports the incident to the infection control team. The nurse is anxious about the risk of HIV transmission and seeks guidance on the next steps. What is the most appropriate next step in the management of this patient?

A 28-year-old surgeon presents for follow-up 8 months after a needlestick injury sustained while performing an appendectomy with unknown HIV/HBV/HCV status. At the time of exposure, He was fully vaccinated against HBV (confirmed anti-HBs >10 mIU/mL). He initiated PEP (tenofovir/emtricitabine + dolutegravir) but discontinued after 1 week due to nausea. Previous testing:

• • HIV-1/2 combo assay (4 months ago): Negative.
  • Anti-HCV antibody (4 months ago): Negative.

He is asymptomatic, with normal vitals and physical exam. What is the most appropriate diagnostic study at this time?

A 29-year-old male with a new positive HIV test presents for evaluation. His partner was recently diagnosed with AIDS. He has no symptoms and normal vitals/exam. He had IV heroin use, ex-smoker

Relevant Labs:

• HIV-1 RNA:28,000 copies/mL (
• CD4:420/mm³
• Hepatitis Serology:
  • Anti-HBs (+), Anti-HBc (–), HBsAg (–)
  • Anti-HAV (–)
• VZV IgG (–)

How should this patient be vaccinated?

A 42-year-old truck driver from Karachi presents to a public hospital with purple, painless skin lesions on his left leg that appeared 1 month ago and have slowly enlarged. He reports a 10-kg weight loss over 3 months and occasional night sweats. He has past history of sexually transmitted infections, treated for syphilis. He has no prior history of HIV testing. On examination, he has 3 violaceous, oval plaques (1–2 cm) on the left calf. Oral thrush and generalized lymphadenopathy.

Investigations:

• HIV-1 ELISA: Positive.
• CD4 count: 55 cells/mm³ (Severe immunosuppression).
• HIV viral load: 48,000 copies/mL.
• Skin biopsy: Pending

Anti-retroviral therapy was started. Which of the following primary prophylaxis is needed for this patient?

Which one is the correct answer?

A 46-year-old businessman from Karachi presents for a routine check-up. He reports no symptoms but admits to unprotected sex with multiple partners over the past year. He occasionally consumes alcohol but denies tobacco or drug use.

HIV-1 ELISA: Positive

CD4 count: 584/mm³ 

HIV viral load: 28,000 copies/mL.

Serology Results:

• Toxoplasma IgG (+)
• CMV IgG (+)
• Hepatitis A IgG (+)
• HBsAg (–), Anti-HBs (+), Anti-HBc (–):
• HCV: Negative

Which of the following is the most urgent next step in this patient