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A 35-Year-Old Woman Who Was Recently Diagnosed with HIV Comes

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A 35-year-old woman who was recently diagnosed with HIV comes to the office for evaluation after moving to New York City from Tucson, Arizona.  She began taking highly active antiretroviral therapy 9 months ago and has been compliant with the regimen.  She also takes trimethoprim/sulfamethoxazole for Pneumocystis pneumonia prophylaxis.  The patient reports no symptoms except for occasional nausea.  Her CD4 count 3 months ago was 210/mm3.  She also has a history of asthma, which is stable with inhaled beclomethasone therapy.
Vital signs are within normal limits.  Examination shows no abnormalities.
Laboratory results are as follows:
A 35-year-old woman who was recently diagnosed with HIV comes to the office for evaluation after moving to New York City from Tucson, Arizona.  She began taking highly active antiretroviral therapy 9 months ago and has been compliant with the regimen.  She also takes trimethoprim/sulfamethoxazole for Pneumocystis pneumonia prophylaxis.  The patient reports no symptoms except for occasional nausea.  Her CD4 count 3 months ago was 210/mm<sup>3</sup>.  She also has a history of asthma, which is stable with inhaled beclomethasone therapy. Vital signs are within normal limits.  Examination shows no abnormalities. Laboratory results are as follows:   The patient's viral load is undetectable. Chest x-ray shows no acute disease. Which of the following is the best next step in management of this patient? A) Azithromycin for Mycobacterium avium complex prophylaxis B) Fluconazole for coccidiomycosis prophylaxis C) No changes are needed in her medication regimen D) Stop inhaled beclomethasone E) Stop trimethoprim-sulfamethoxazole for Pneumocystis prophylaxis The patient's viral load is undetectable.
Chest x-ray shows no acute disease.
Which of the following is the best next step in management of this patient?

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