This HIV-positive patient with a viral load of 750,000 copies of HIV RNA/ml and a total CD4 count of 50 is at an increased risk for a number of infectious diseases. For which of the following diseases is the patient at no more added risk than an immunocompetent host?

The advent of triple therapy or a therapeutic "cocktail" has had a marked effect on AIDS patients. The combination of drugs work together as reverse transcriptive inhibitors and a protease inhibitor. Patients improve rapidly, their CD4 lymphocyte counts increase, and their HIV viral load is drastically reduced, often to <50 copies per ml. On the other hand, an untreated HIVpositive patient with a low CD4 and a high viral load a) is at increased risk of oppounistic infection and b) has a much greater chance of developing AIDS than if the viral load was <50,000. The patient is infectious and his HIV antibody screening test will be positive. The high viral load, however, is not a predictor of response to therapy. Many patients with high viral loads do very well on triple therapy, although resistance to one or more of the agents may subsequently occur. A low CD4 count does not predict progression to AIDS but does indicate increased chance of oppounistic infection such as those listed. Kaposi's sarcoma, which has been linked to herpesvirus type 8, pneumocystis, and mycobacterial disease are three of the most prevalent oppounistic infections. While HIV-positive patients contract pneumococcal pneumonia, they are probably at no more risk than the general population, as protection against pneumococcal disease is linked to the presence of anticapsular antibody. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition