Past medical history of hiv treated with abacavir

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Angel is a 23-year-old cisgender woman with a past medical history of HIV treated with abacavir/dolutegravir/lamivudine (ABC/DTG/3TC). Her last CD4 count was 550 cell/mm3, and her HIV viral load was undetectable 9 months ago. Her primary concern today is a recent sexually transmitted infection exposure. She reports that she is aware of a recent male sexual partner who tested positive for syphilis. Upon reviewing her allergy history, Angel says that she is allergic to penicillin. She reports she took the medication 15 years ago and developed itching without rash and has not taken it since. Lab testing reveals a positive Treponemal IgG and an RPR of 1:64; a prior Treponemal IgG was negative 9 months ago. What do you recommend? Choose: Prescribe doxycycline 100 mg by mouth twice daily for 7 days Prescribe azithromycin 1 g by mouth in a single dose Re-challenge with amoxicillin 250 mg by mouth; if tolerated, prescribe benzathine penicillin G administered intramuscularly (IM) Referral to allergy specialist for further testing.

Reference no: EM133731873

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