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55 Cards in this Set

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A patient is started on antiretroviral therapy for her newly diagnosed HIV infection. Which of the following regimens is a preferred regimen for initial HIV treatment?


Answer


AAtazanavir + ritonavir + emtricitabine + tenofovir


BAbacavir + lamivudine + nevirapine


CEmtricitabine + lamivudine + zidovudine + delavirdine


DEtravirine + nevirapine + ritonavir + saquinavir


ENone of the above

AAtazanavir + ritonavir + emtricitabine + tenofovir

A HIV-positive patient with a history of poor medication adherence has a CD4+ count less than 50 cells/µL. He develops cytomegalovirus (CMV) retinitis. Which medication should be recommended?


Answer


AFluconazole


BValganciclovir


CClarithromycin


DNystatin


ETrimethoprim-Sulfamethoxazole

BValganciclovir

Devin was started on antiretroviral therapy and had poor adherence. He was put into counseling and a patient support group. Despite intensive help, he was not able to demonstrate adherence with therapy. Devin has decided that forces other than medicine will decide if he lives or if he dies. Today his CD4+ count is 105 cells/µL. Choose the correct statements: (Select ALL that apply.)


Answer


ADevin should be restarted on HIV medications right away.


BIt may be best for Devin to defer treatment until he is able to take the medicines as directed.


CTaking medications intermittently will increase the risk of drug resistance.


DDevin should receive prophylaxis to prevent Cytomegalovirus infection.


EDevin should be educated on safe sex practices


BIt may be best for Devin to defer treatment until he is able to take the medicines as directed.


CTaking medications intermittently will increase the risk of drug resistance.



EDevin should be educated on safe sex practices

Which of the following medications are nucleoside/tide reverse transcriptase inhibitors? (Select ALL that apply.)


Answer


AFuzeon


BViread


CReyataz


DEpivir


EViramune

BViread



DEpivir

Patrick requires prophylaxis for Pneumocystis pneumonia. Which medications could be recommended for prophylaxis ofPneumocystis pneumonia depending on the patients allergies? (Select ALL that apply.)


Answer


ATrimethoprim-Sulfamethoxazole Single Strength 1 tablet PO daily


BTrimethoprim-Sulfamethoxazole Double Strength 1 tablet PO daily


CClarithromycin 500 mg PO BID


DMoxifloxacin 400 mg PO daily


EDapsone 100 mg PO daily

ATrimethoprim-Sulfamethoxazole Single Strength 1 tablet PO daily


BTrimethoprim-Sulfamethoxazole Double Strength 1 tablet PO daily



EDapsone 100 mg PO daily

A laboratory technician had an accidental needlestick injury from a needle potentially contaminated with HIV. Which drug combination is the preferred regimen for post-exposure prophylaxis therapy?


Answer


AZidovudine + nevirapine


BZidovudine + abacavir


CRaltegravir + tenofovir + emtricitibine


DZidovudine + lamivudine + nevirapine


EZidovudine + lamivudine + abacavir

CRaltegravir + tenofovir + emtricitibine

RP comes into the pharmacy with a prescription for Viread tablets. What is the correct dose for a patient without renal impairment?


Answer


A100 mg PO daily


B150 mg PO daily


C200 mg PO daily


D300 mg PO daily


E400 mg PO BID

D300 mg PO daily

A patient comes in to fill the following prescription: Atripla 1 tablet PO QHS. She also asks for a refill on her Sustiva tablets as she does not want to run out of her medicine. You should tell the patient which of the following?


Answer


AYou cannot fill them because there is a drug interaction.


BHer medications will be ready in a few minutes.


CYou fill them but tell the patient to separate the doses by 6 hours apart from one another.


DYou cannot fill them because there is duplicate therapy of tenofovir.


EYou cannot fill them because there is duplicate therapy of efavirenz.

EYou cannot fill them because there is duplicate therapy of efavirenz.

A patient is prescribed Epzicom one tablet daily. Epzicom contains the following medications:


Answer


AZidovudine and lamivudine


BEfavirenz and tenofovir


CEmtricitabine and tenofovir


DLamivudine and abacavir


EAbacavir and zidovudine

DLamivudine and abacavir

Ernesto has been on antiretroviral therapy for three years and has been compliant. His doctor recently noticed some side effects from the medicines he is taking. Ernesto is experiencing dyslipidemia, fat maldistribution and insulin resistance. These side effects most commonly occur with the following class of medications:


Answer


ANucleoside Reverse Transcriptase Inhibitors


BNon-Nucleoside Reverse Transcriptase Inhibitors


CProtease Inhibitors


DIntegrase Inhibitors


EEntry Inhibitors

CProtease Inhibitors

A patient is prescribed Atripla. Atripla contains the following medications:


Answer


ATenofovir, emtricitabine, and efavirenz


BAtazanavir, ritonavir, emtricitabine


CTenofovir, etravirine, and rilpivirine


DAtazanavir, nevirapine, and delavirdine


EEfavirenz, lopinavir, and ritonavir

ATenofovir, emtricitabine, and efavirenz

A patient has been taking atazanavir, ritonavir, tenofovir and emtricitabine for the past two years. The patient is highly compliant and doing well on the medications. The patient understands that atazanavir should not be taken with this class of medications:


Answer


APhosphodiesterase inhibitors


BBeta blockers


CProton pump inhibitors


DAnticholinergics


ETricyclic antidepressants

CProton pump inhibitors


Which of the following statements are accurate regarding Nucleoside Reverse Transcriptase Inhibitors (NRTIs)? (Select ALLthat apply.)


Answer


AThe entire class has a black box warning for pancreatitis.


BThe entire class has a black box warning for Stevens-Johnson Syndrome.


CThey interfere with viral replication by binding to the catalytic site of reverse transcriptase.


DThe entire class has a black box warning for lactic acidosis.


EThey do not undergo hepatic transformation via the CYP 450 pathway.

CThey interfere with viral replication by binding to the catalytic site of reverse transcriptase.


DThe entire class has a black box warning for lactic acidosis.


EThey do not undergo hepatic transformation via the CYP 450 pathway.

A pharmacist receives a prescription for Truvada. What medications are in this product?


Answer


AEmtricitabine + tenofovir + efavirenz


BEmtricitabine + tenofovir + rilpivirine


CZidovudine + lamivudine


DZidovudine + lamivudine + abacavir


EEmtricitabine + tenofovir

EEmtricitabine + tenofovir

Which of the following medications should be taken on an empty stomach? (Select ALL that apply.)


Answer


AAtazanavir


BEfavirenz


CDarunavir


DRitonavir


EDidanosine

BEfavirenz



EDidanosine

Tanya comes for a routine clinic appointment today. She has HIV and has been stable on her regimen of darunavir plus ritonavir, lamivudine, and emtricitabine. Which of the following statements regarding ritonavir are correct? (Select ALL that apply.)


Answer


ARitonavir is used as monotherapy for treating HIV during pregnancy.


BRitonavir is a strong inhibitor of 3A4 and 2D6 and has many drug interactions.


CRitonavir should be taken on an empty stomach.


DThe brand name is Norvir.


ERitonavir can be used to increase the serum drug level of another, concurrently-used protease inhibitor.

BRitonavir is a strong inhibitor of 3A4 and 2D6 and has many drug interactions.



DThe brand name is Norvir.


ERitonavir can be used to increase the serum drug level of another, concurrently-used protease inhibitor.

JR, who is clinically depressed and self-medicating with St. John’s wort, was recently diagnosed with HIV/AIDS and was started on the following regimen: Prezista 800 mg + 100 mg ritonavir PO daily Truvada 1 tablet PO daily Allergies = sulfa (mild rash). Which of the following counseling points are appropriate regarding Prezista? (Select ALL that apply.)


Answer


ADiscuss with his doctor regarding his St. John’s wort as it may decrease the levels of Prezista.


BTake on an empty stomach and swallow the tablet whole.


CTake his Prezista with the ritonavir.


DChanges in body fat may occur while you are taking this medication.


EThe patient should be instructed to monitor for rash given his sulfa allergy and contact his doctor if occurs.

ADiscuss with his doctor regarding his St. John’s wort as it may decrease the levels of Prezista.



CTake his Prezista with the ritonavir.


DChanges in body fat may occur while you are taking this medication.


EThe patient should be instructed to monitor for rash given his sulfa allergy and contact his doctor if occurs.

A pharmacist receives a prescription for Trizivir. What medications are in this product?


Answer


AZidovudine + lamivudine


BZidovudine + lamivudine + abacavir


CEmtricitabine + tenofovir


DEmtricitabine + tenofovir + efavirenz


EEmtricitabine + tenofovir + rilpivirine

BZidovudine + lamivudine + abacavir

A patient is taking indinavir. Which of the following statements regarding indinavir are correct? (Select ALL that apply.)


Answer


AThis medication can cause nephrolithiasis. Drink at least 48 ounces of water daily.


BCapsules are sensitive to moisture; desiccant should remain in the bottle.


CThe brand name is Invirase.


DThis medication should be taken once daily.


EThis medication interacts with many medications. Tell your pharmacist and/or doctor if you start a new medication, including herbal products.

AThis medication can cause nephrolithiasis. Drink at least 48 ounces of water daily.


BCapsules are sensitive to moisture; desiccant should remain in the bottle.



EThis medication interacts with many medications. Tell your pharmacist and/or doctor if you start a new medication, including herbal products.

A healthcare worker has started post-exposure prophylaxis therapy for a needlestick injury. How long should the patient take the recommended therapy?


Answer


A2 weeks


B4 weeks


C6 weeks


D12 weeks


E24 weeks


B4 weeks

Which antiretroviral is available in intravenous formulation that is used to prevent perinatal transmission of HIV?


Answer


ASustiva


BSelzentry


CRetrovir


DRescriptor


EKaletra

CRetrovir

A patient gave the pharmacist a prescription for Viread 300 mg po daily. Which of the following is an appropriate generic substitution for Viread?


Answer


ATenofovir


BAtazanavir


CEmtricitabine


DEmtricitabine and tenofovir


ENevirapine

ATenofovir

Which of the following statements are true regarding CD4+ T-cells? (Select ALL that apply.)


Answer


AOnce they fall below a certain level, there is an increased risk of opportunistic infections.


BThey are commonly used to assess severity of disease.


CThey serve as the primary marker for determining development of drug resistance.


DThey are the primary target of the immune system by HIV.


EThey are not needed for survival.

AOnce they fall below a certain level, there is an increased risk of opportunistic infections.


BThey are commonly used to assess severity of disease.



DThey are the primary target of the immune system by HIV.

A patient gave the pharmacist a prescription for Sustiva 600 mg PO daily. Which of the following is an appropriate generic substitution for Sustiva?


Answer


AEmtricitabine


BEtravirine


CEfavirenz


DNevirapine


EAbacavir


CEfavirenz

HIV is a communicable disease. Transmission can occur by: (Select ALL that apply.)


Answer


ABlood


BSemen


CVaginal fluid


DSaliva


EBreast milk

ABlood


BSemen


CVaginal fluid



EBreast milk

A patient with HIV has a CD4+ count of 93 cells/µL and is toxoplasma IgG positive. Based on CD4+ count, which of the following opportunistic infections should this patient receive prophylaxis against at this time? (Select ALL that apply.)


Answer


APneumocystis pneumonia


BToxoplasma gondii


CMycobacterium avium


DCytomegalovirus


ECryptococcus meningitis

APneumocystis pneumonia


BToxoplasma gondii

GH comes into the pharmacy with a prescription for Emtriva capsules. What is the correct dose for a patient without renal impairment?


Answer


A100 mg PO daily


B150 mg PO daily


C200 mg PO daily


D300 mg PO daily


E400 mg PO BID

C200 mg PO daily

A patient gave the pharmacist a prescription for Isentress. Which of the following is an appropriate generic substitution forIsentress?


Answer


ARilpivirine


BTenofovir


CRaltegravir


DTipranavir


EMaraviroc


CRaltegravir

Tammi comes into the pharmacy with a prescription for Sustiva. What is the correct dose of this medication?


Answer


A100 mg PO QHS


B200 mg PO QHS


C400 mg PO QHS


D600 mg PO QHS


E800 mg PO QHS

D600 mg PO QHS

Max comes to the emergency department with a severe skin rash and epidermal detachment. He is diagnosed with toxic epidermal necrolysis (TEN). He states he was recently started on some HIV medications. Which of the following medications is most likely the cause of his TEN reaction?


Answer


ANevirapine


BDelavirdine


CEmtricitabine


DStavudine


ETipranavir

ANevirapine

JR, a 32 year old HIV positive male, is initiated on antiretroviral therapy. Which of the following protease inhibitor based regimens are considered first line therapy and are dosed once daily? (Select ALL that apply.)


Answer


ARaltegravir + lamivudine + zidovudine


BAtazanavir + ritonavir + emtricitabine + tenofovir


CDelavirdine + lamivudine + zidovudine


DLopinavir + ritonavir + abacavir + lamivudine


EDarunavir + ritonavir + emtricitabine + tenofovir

BAtazanavir + ritonavir + emtricitabine + tenofovir



EDarunavir + ritonavir + emtricitabine + tenofovir

Barbara is at risk of developing Mycobacterium avium complex (MAC). Which of the following agents should be given to prevent this opportunistic infection?


Answer


AAzithromycin 1,200 mg PO daily


BTrimethoprim-sulfamethoxazole 1 single strength tab daily


CAzithromycin 1,200 mg PO weekly


DClarithromycin 600 mg PO twice weekly


ETrimethoprim-sulfamethoxazole 1 double strength tab daily

CAzithromycin 1,200 mg PO weekly

Efavirenz is a preferred agent as part of initial antiretroviral therapy in HIV-infected patients. Which of the following statements concerning efavirenz are correct? (Select ALL that apply.)


Answer


AA different agent should be chosen in women with high pregnancy potential.


BA single combination tablet of tenofovir, emtricitabine, and efavirenz provides once-daily dosing.


CThis medication should be taken with food.


DIt is important to dispense this medication is the original container and protect from light.


ECNS side effects usually dissipate after a few weeks in most patients.

AA different agent should be chosen in women with high pregnancy potential.


BA single combination tablet of tenofovir, emtricitabine, and efavirenz provides once-daily dosing.



ECNS side effects usually dissipate after a few weeks in most patients.

A HIV positive patient comes in complaining of yellowing of the skin, but is otherwise asymptomatic. Upon further review it was found the patient has asymptomatic jaundice. What medication is he likely receiving that is causing this side effect?


Answer


AReyataz


BEmtriva


CEpivir


DPrezista


EFuzeon

AReyataz

LA is a 31 year old female who recently started antiretroviral therapy. Her medical record shows that 2 months ago she was found to be HIV positive (viral HIV RNA load of 140,000 copies/mL and a CD4+ count of 190 cells/µL) and started on antiretroviral therapy. She now presents with signs and symptoms of Pneumocystis pneumonia and immune reconstitution syndrome. How would you manage her Pneumocystis infection and immune reconstitution syndrome?


Answer


AStart treatment for Pneumocystis pneumonia and continue her current antiretroviral regimen.


BStart treatment for Pneumocystis pneumonia and discontinue her current antiretroviral regimen.


CStart treatment for Pneumocystis pneumonia and change her current antiretroviral regimen since it is not working.


DDo not treat the Pneumocystis pneumonia and continue her current HIV antiretroviral regimen. The Pneumocystis pneumonia infection will resolve on its own with proper antiretroviral therapy.


EStop all medications and treat with corticosteroids only.

AStart treatment for Pneumocystis pneumonia and continue her current antiretroviral regimen.

A patient has a HIV infection and does not want to start drug therapy. Which of the following laboratory parameters would be expected to change over time as described below?


Answer


AThe viral load will decrease and the CD4+ count will increase


BThe viral load will increase and the CD4+ count will decrease


CThe viral load will increase and the CD4+ count will stay the same


DThe viral load with remain the same and the CD4+ count will increase


EBoth the viral load and the CD4+ count will decrease

BThe viral load will increase and the CD4+ count will decrease

Which of the following HIV medications should be taken with food? (Select ALL that apply.)


Answer


AEdurant


BReyataz


CPrezista


DSustiva


EAtripla


AEdurant


BReyataz


CPrezista

A pharmacist receives a prescription for Complera. What medications are in this product?


Answer


AZidovudine + lamivudine


BZidovudine + lamivudine + abacavir


CEmtricitabine + tenofovir


DEmtricitabine + tenofovir + efavirenz


EEmtricitabine + tenofovir + rilpivirine

EEmtricitabine + tenofovir + rilpivirine

A patient gave the pharmacist a prescription for Prezista. Which of the following is an appropriate generic substitution forPrezista?


Answer


ATipranavir


BMaraviroc


CEmtricitabine


DDarunavir


EFosamprenavir

DDarunavir

A physician is considering starting abacavir on a patient diagnosed with HIV. Which of the following statements regarding abacavir is correct? (Select ALL that apply.)


Answer


AThis medication can cause a severe hypersensitivity reaction.


BPatients must be screened for the HLA-B 1502 allele. If positive, the medication should not be given.


CWhen combined with lamivudine, the brand name is Truvada.


DAbacavir is a protease inhibitor.


EThe brand name is Ziagen.


AThis medication can cause a severe hypersensitivity reaction.



EThe brand name is Ziagen.

In which of the following scenarios should antiretroviral therapy be initiated regardless of the CD4 count? (Select ALL that apply.)


Answer


AA 21 year old asymptomatic women with confirmed HIV who is eager to start therapy.


BPresence of an AIDS defining illness (e.g., Kaposi's sarcoma).


CA 33 year old male who is co-infected with hepatitis C virus.


D24 year old pregnant women with HIV.


E49 year old male with HIV-associated nephropathy.

AA 21 year old asymptomatic women with confirmed HIV who is eager to start therapy.


BPresence of an AIDS defining illness (e.g., Kaposi's sarcoma).


CA 33 year old male who is co-infected with hepatitis C virus.


D24 year old pregnant women with HIV.


E49 year old male with HIV-associated nephropathy.

Adherence is critical to successful antiretroviral therapy. When counseling a patient on his antiretroviral regimen, which of the following statements regarding adherence would be most accurate?


Answer


ATo achieve the best outcome, you must never miss a dose. If you miss a dose, resistance will develop, and we will not be able to treat your HIV.


BEveryone misses doses occasionally. If you miss a dose or two every couple of days, it is no big deal as long as you double your dose on the days you missed.


CEveryone misses doses occasionally; however research has shown to achieve the best control of your HIV infection, you should take 95 out of every 100 doses (or more) as prescribed by your doctor.


DEveryone misses doses occasionally; however research has shown to achieve the best control of your HIV infection, you should take 75% of your prescribed doses.


EAs long as protease inhibitors are boosted with ritonavir and all antiretrovirals are taken with food to facilitate absorption, missing doses becomes irrelevant.


CEveryone misses doses occasionally; however research has shown to achieve the best control of your HIV infection, you should take 95 out of every 100 doses (or more) as prescribed by your doctor.

The primary care doctor of DJ, a 52 year old HIV positive male with a CD4 count of 142 cells/µL who has a history of hyperlipidemia treated with simvastatin and poorly controlled schizophrenia treated with ziprasidone, has decided to initiate antiretroviral therapy. Which of the following statements are true regarding initiating antiretroviral therapy and other supportive care in DJ? (Select ALL that apply.)


Answer


AChange his simvastatin to pravastatin.


BInitiate sulfamethoxazole/trimethoprim for prevention of Pneumocystis.


CConsider initiation of an atazanavir or darunavir based regimen as they are both preferred agents and less likely to be associated with hyperlipidemia.


DConsider initiation of a efavirenz based regimen as it has the least effect on his psychiatric disease.


EReinforce the importance of diet and exercise in the setting of hyperlipidemia.


AChange his simvastatin to pravastatin.


BInitiate sulfamethoxazole/trimethoprim for prevention of Pneumocystis.


CConsider initiation of an atazanavir or darunavir based regimen as they are both preferred agents and less likely to be associated with hyperlipidemia.



EReinforce the importance of diet and exercise in the setting of hyperlipidemia.

A pharmacist receives a prescription for Combivir. What medications are in this product?


Answer


AEmtricitabine + tenofovir


BLopinavir + ritonavir


CEmtricitabine + tenofovir + rilpivirine


DZidovudine + lamivudine


EZidovudine + abacavir

DZidovudine + lamivudine

Which antiretroviral is most likely to cause anemia?


Answer


ALamivudine


BFlucytosine


CAbacavir


DZidovudine


EEfavirenz


DZidovudine

What is a preferred ART regimen in a pregnant woman?


Answer


AEfavirenz + tenofovir + emtricitabine


BLopinavir + ritonavir + zidovudine + lamivudine


CEfavirenz + abacavir + lamivudine


DTenofovir + lamivudine + zidovudine + ritonavir


ENone of the above, pregnant women should not be started on ART

BLopinavir + ritonavir + zidovudine + lamivudine

TW comes into the pharmacy with a prescription for Isentress tablets. What is the correct dose for this medication?


Answer


A100 mg PO daily


B150 mg PO daily


C200 mg PO daily


D300 mg PO daily


E400 mg PO BID

E400 mg PO BID

A patient is started on Videx EC 400 mg daily. Which of the following patient points are appropriate for the pharmacist to review with the patient? (Select ALL that apply.)


Answer


AThe generic name for this medication is didanosine.


BThis medication should be taken on an empty stomach.


CStore the medication in tightly closed bottles at room temperature.


DCommon side effects such as fat redistribution, hyperlipidemia, hyperglycemia and insulin insensitivity.


ERarely, this medication can cause severe liver problems and lactic acidosis.

AThe generic name for this medication is didanosine.


BThis medication should be taken on an empty stomach.


CStore the medication in tightly closed bottles at room temperature.



ERarely, this medication can cause severe liver problems and lactic acidosis.

A patient comes to the pharmacy with a new prescription for emtricitabine. Choose the correct drug class for emtricitabine:


Answer


ANucleoside Reverse Transcriptase Inhibitor


BNon-Nucleoside Reverse Transcriptase Inhibitor


CCCR5 Receptor Antagonist


DIntegrase Inhibitor


EProtease Inhibitor

ANucleoside Reverse Transcriptase Inhibitor

A pharmacist receives a prescription for Stribild. What medications are in this product?


Answer


AAtazanavir + ritonavir + emtricitabine + tenofovir


BRaltegravir + emtricitibine + tenofovir


CDolutegravir + rilpivirine + emtricitibine + tenofovir


DElvitegravir + cobicistat + emtricitabine + tenofovir


ERilpivirine + emtricitibine + tenofovir

DElvitegravir + cobicistat + emtricitabine + tenofovir

A patient has been on antiretroviral therapy now for eight years. During the last clinic visit, the patient had signs of drug resistance on his laboratory work up. The CD4+ count was 350 cells/ µL. Which of the following medications should this patient be placed on to prevent an opportunistic infection (OI)?


Answer


ATrimethoprim-sulfamethoxazole double strength should be initiated.


BAzithromycin should be initiated.


CValganciclovir should be initiated.


DThis patient should not be started on any prophylactic medications at this time.


ETrimethoprim-sulfamethoxazole single strength should be initiated.

DThis patient should not be started on any prophylactic medications at this time.

Which of the following statements are valid reasons for changing antiretroviral therapy? (Select ALL that apply.)


Answer


ADrug toxicities


BNon-adherence to the regimen


CAn undetectable viral load


DVirologic failure


EClinical cure of an opportunistic infection.

ADrug toxicities


BNon-adherence to the regimen



DVirologic failure

Wendy has a new prescription for Kaletra. Which of the following statements regarding Kaletra is correct?


Answer


AKaletra is a combination product of ritonavir and saquinavir.


BKaletra oral solution should be taken with food.


CKaletra has little risk of drug interactions.


DKaletra tablets should be taken on an empty stomach.


EKaletra is a non-nucleoside reverse transcriptase inhibitor.

BKaletra oral solution should be taken with food.

Which of the following statement(s) regarding tenofovir are correct? (Select ALL that apply.)


Answer


ATenofovir can cause osteomalacia and lactic acidosis


BTenofovir is a nucleotide reverse transcriptase inhibitor


CTenofovir can be used concurrently with didanosine


DTenofovir is not dose adjusted in renal impairment


ETenofovir tablets must be taken with meals.

ATenofovir can cause osteomalacia and lactic acidosis


BTenofovir is a nucleotide reverse transcriptase inhibitor

The primary goals of antiretrovirals are to: (Select ALL that apply.)


Answer


ARestore and preserve the immune function.


BSuppress HIV viral load.


CDecrease CD4 lymphocyte count.


DDecrease incidence of opportunistic infections.


EReduce the risk of HIV transmission.


ARestore and preserve the immune function.


BSuppress HIV viral load.



DDecrease incidence of opportunistic infections.


EReduce the risk of HIV transmission.