Which option is NOT recommended for preventing opportunistic infections in people with HIV?

• A. Vaccinations as appropriate
• B. Prophylaxis for toxoplasma if CD4 < 100
• C. MAC prophylaxis if CD4 < 50
• D. Daily unpasteurized dairy products

Answer: (D)

Prevention of opportunistic infections in people with HIV relies on two key ideas: giving vaccines to build protection against common pathogens and using targeted antimicrobial prophylaxis based on how weakened the immune system is (CD4 count) to prevent specific infections. Vaccines should be given as appropriate, with attention to any live vaccines being avoided if immune function is very low. Prophylaxis for toxoplasma gondii is used when the CD4 count drops below a certain level to prevent toxoplasmic encephalitis, and MAC prophylaxis is used when the CD4 count falls below another threshold to prevent Mycobacterium avium complex infection. Daily unpasteurized dairy products, however, do not prevent infections; they can introduce harmful pathogens such as Listeria, posing a real risk to someone with HIV. So this option is not recommended and is potentially dangerous.