National programmes: ART policy: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

PSM · National programmes: ART policy

Sample item

A newly diagnosed 30-year-old woman with HIV-1 infection is asymptomatic (WHO clinical stage 1) with a CD4 count of 620 cells/microlitre. According to the Indian national programme, when should antiretroviral therapy begin?

AOnly when WHO clinical stage 3 developsBNow, irrespective of CD4 count and clinical stage, after counsellingCWhen the CD4 count falls below 350DWhen the CD4 count falls below 500

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Now, irrespective of CD4 count and clinical stage, after counselling

India follows a test-and-treat policy: every person diagnosed with HIV is offered antiretroviral therapy irrespective of CD4 count or clinical stage, after adherence counselling and baseline evaluation. Early treatment improves outcomes and lowers transmission. Older CD4-based thresholds are no longer used.

Option by option

A. Only when WHO clinical stage 3 develops
Waiting for stage 3 disease allows avoidable immune damage and transmission.
B. Now, irrespective of CD4 count and clinical stage, after counselling (correct)
Correct. Treatment is offered to all diagnosed persons irrespective of CD4 count and stage.
C. When the CD4 count falls below 350
A threshold of 350 belongs to an earlier guideline era.
D. When the CD4 count falls below 500
A threshold of 500 was a later interim threshold, also superseded.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is B, Now, irrespective of CD4 count and clinical stage, after counselling. India follows a test-and-treat policy: every person diagnosed with HIV is offered antiretroviral therapy irrespective of CD4 count or clinical stage, after adherence counselling and baseline evaluation.

Why is "Only when WHO clinical stage 3 develops" not the answer?

Waiting for stage 3 disease allows avoidable immune damage and transmission.

Why is "When the CD4 count falls below 350" not the answer?

A threshold of 350 belongs to an earlier guideline era.

Why is "When the CD4 count falls below 500" not the answer?

A threshold of 500 was a later interim threshold, also superseded.

What concept does this question test?

It tests National programmes: ART policy in PSM. Early treatment improves outcomes and lowers transmission. Older CD4-based thresholds are no longer used.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study National programmes: ART policy?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.