If It's Not One Thing, It's Another — The Experts Weigh In

Last week, we asked how you would manage a patient with newly diagnosed AIDS, suspected Pneumocystis jirovecii pneumonia (PCP), and acute renal failure. So far, we've received about a dozen responses, and readers seem to have reached a consensus: confirm the PCP diagnosis, explore the causes of the renal failure, and stop the patient's tenofovir — even if tenofovir isn't the cause. Now, two experts (a nephrologist and an HIV specialist) weigh in.

A 54-year-old African-American man was admitted to the hospital after being found unconscious by emergency medical service responders following several days of reported fevers and lethargy. His girlfriend reported that he had a history of injection-drug use and hepatitis C virus (HCV) infect…