New HIV

A patient arrives with newly diagnosed HIV, low CD4 (82), diarrhea, abdominal discomfort, constitutional symptoms and weight loss

In this patient, the CD4 is low enough that anti-retrovirals (ARVs) should be started, however, it is important to look for tuberculosis (TB) and treat that first to avoid immune reconstitution issues. If the chest radiograph is unrevealing, ultrasound can be used to search abdominal organs for signs of TB.