1. A 37 years old man who is HIV positive has noticed multiple 0.5 to 1.2 cm, plaque-like reddish-purple skin lesions on his face, trunk, and extremities. Some of the larger lesions appear to be nodular. These lesions have appeared over the past 6 months and have slowly enlarged. Molecular analysis of the spindle cells found in these skin lesions is likely to reveal the genome of which of the following viruses?

• Cytomegalovirus
• Epstein-Barr virus
• Human herpesvirus-8
• Adenovirus

2. An epidemiologic study is conducted to determine risk factors for HIV infection. The study documents that persons with coexisting sexually transmitted diseases such as chancroid are more likely to become HIV positive. It is postulated that an inflamed mucosal surface is an ideal location for the transmission of HIV during sexual intercourse. Which of the following cells in these mucosal surfaces is most instrumental in transmitting HIV to CD4+ T lymphocytes?

• Dendritic cells
• CD8+ cells
• Natural killer cells
• Neutrophils

According to World Health Organization's immunologic classification for established HIV infection, an 18-month-old child with a CD4 count of 23 would be defined as:

• Mild disease
• Moderate disease
• Severe disease
• None of the above

4. A 23 years old male, diagnosed with HIV, presented with complaints of severe weight loss and fever. He was diagnosed with pulmonary TB. He gives h/o recurrent episodes of oral candidiasis and chronic diarrhoea for a month. What is the most likely clinical stage of his disease?

• Clinical stage 1
• Clinical stage 2
• Clinical stage 3
• Clinical stage 4

5. All of the following are true regarding immune reconstitution inflammatory syndrome (IRIS), EXCEPT:

• Typically occurs in the first 9 months following initiation of ART
• Can manifest as worsening of a known opportunistic infection
• IRIS secondary to PTB may occur with CD4 counts >200 cells/microL
• High HIV RNA at the time of treatment initiation increase the risk of developing IRIS

6. A nurse in your ward has sustained a needle prick injury while collecting blood from a patient diagnosed with HIV. What is the latest time that HIV post-exposure prophylaxis may be given?

• 72 hours after the initial exposure
• 48 hours after the initial exposure
• 24 hours after the initial exposure
• 12 hours after the initial exposure

7. A 27-year-old woman states that she has missed her menstrual period for 6 weeks. UPT was positive and USG showed live intrauterine pregnancy of 6 weeks. A routine antenatal check-up showed a positive HIV rapid screen test. Which of the following drugs should be avoided in this patient?

• Tenofovir disoproxil fumarate
• Emtricitabine
• Raltegravir
• Dolutegravir

8. A 50-year-old PLHIV patient with a CD4 of 100 is suspected to have Progressive Disseminated Histoplasmosis (PDH). He is planning for a urine Histoplasma Antigen. Which of the following statements is TRUE about this test?

• It is highly specific for histoplasma with no cross reactivity
• It correlates with the severity of illness
• It has a higher rate of positivity in chronic cavitary histoplasma than PDH
• This test has less sensitivity in immunocompromised patients.

9.  A known HIV-1-positive lady gets pregnant. At the 34th week of pregnancy, her HIV viral load is seen to be 2500 copies/ml. What is the prophylaxis that is advised to the infant of this mother when he/she is born in case the mother is willing to exclusively breastfeed her baby?

• Syp. Nevirapine for 6 weeks
• Syp Zidovudine for 6 weeks since nevirapine is only effective in HIV-2 infections
• Syp. Nevirapine + Syp. Zidovudine for 6 weeks
• Syp. Nevirapine + Syp Zidovudine for 12 weeks

10. Frascati criteria are used for the diagnosis of:

• Creutzfeldt Jakob disease
• Cryptococcal meningitis
• HAND
• Invasive aspergillosis