One year after immigration to Switzerland, a 31 year-old Cameroonian woman with no medical history develops progressive asthenia and low-grade fever with no other specific complaints. HIV serology is positive and the patient is hospitalized for investigation. On admission she appears chronically ill, temperature is 38.1°C, heart rate 108 beats/minute, respiratory rate 16/minute and blood pressure 165/55. Cardiopulmonary and abdominal examination are normal. Asymptomatic oral candidiasis is observed. No lymphadenopathy, organomegaly, skin lesions, ocular abnormalities or other focal signs are found.
What are the factors that specifically interact to produce opportunistic infections in HIV-positive patients?
1 Depression of cell-mediated immunity related to the stage of HIV infection
2 Environmental exposure to opportunistic pathogens
3 Reactivation of endogenous latent opportunistic infection
4 Previous use of multiple antibiotics
5 Choices 1, 2 and 3