A 31-Year-Old Man Comes to the Office Due to a Week

question 293

Multiple Choice

A 31-year-old man comes to the office due to a week of fever, night sweats, sore throat, malaise, and extreme fatigue.  He has no prior medical conditions and takes no medications.  The patient has had multiple sexual partners over his lifetime and uses condoms inconsistently.  Temperature is 38 C (100.4 F) , blood pressure is 110/80 mm Hg, pulse is 92/min, and respirations are 20/min.  Physical examination shows multiple shallow ulcers on the oropharyngeal mucosa, and the tonsils are enlarged and hyperemic.  Cervical and axillary lymphadenopathy is present, and there is a generalized, erythematous, maculopapular skin rash.  HIV testing shows the following results: Which of the following best explains this patient's laboratory findings?

• A)Early viral infection before serologic response
• B)High antigenic variability of the surface glycoprotein
• C)Inadequate antibody production due to immunosuppression
• D)Insufficient viral replication necessary for antibody production
• E)Underlying primary immunodeficiency

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