26th June 2023

A 36-year-old man presents to the outpatient GUM clinic for follow-up post-diagnosis of HIV (CD4+: 53 cells/mm3) and gonorrhoea

A 36-year-old man presents to the outpatient GUM clinic for follow-up post-diagnosis of HIV (CD4+: 53 cells/mm3) and gonorrhoea. He has a history of genital herpes, which is well managed with oral acyclovir, and asthma which is controlled with PRN salbutamol. He was diagnosed with CMV 5 years ago. On taking a social history, he says he only smokes 5 cigarettes a week and smokes about 2 joints of cannabis most weekends which he has done for the last year. He follows a strict vegan diet.

Which of the following aspects of his history most increases his risk of a primary brain lesion?

Select the SINGLE most appropriate option from the list below. Select ONE option only.