Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 30-year-old woman is evaluated in follow-up after being recently diagnosed with HIV infection. She is asymptomatic. Medical history is unremarkable, and she takes no medications; she has not yet started antiretroviral therapy. She received all scheduled childhood immunizations.
On physical examination, vital signs are normal. She has shotty cervical lymphadenopathy, but the examination is otherwise unremarkable.
Laboratory studies:
| Absolute CD4 cell count | 461/µL |
| HIV viral load | 44,874 copies/mL |
| Hepatitis A IgG antibody | Negative |
| Hepatitis B surface antibody | Positive |
| Hepatitis B surface antigen | Negative |
| Hepatitis C antibody | Negative |
Which of the following immunizations should this patient receive today?
A. Hepatitis A vaccine
B. Hepatitis B vaccine
C. Human papillomavirus vaccine
D. Pneumococcal conjugate vaccine
E. Pneumococcal polysaccharide vaccine
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