Answer: D. Both B and C
According to the 2018 NCCN guidelines, ART should be offered immediately to patients who are not already receiving it. However, providers should consider starting ART 7 or more days before or after the start of cancer therapy to provide enough time for tolerance to either therapy to be established. ART may also need to be adapted in accordance with cancer therapy. ART should not be interrupted during cancer therapy because doing so can increase the risk of immunologic compromise, opportunistic infections, and death.1
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1. Reid E, Suneja G, Ambinder RF, et al. Cancer in People Living With HIV, Version 1.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2018;16:986-1017. doi: 10.6004/jnccn.2018.0066.
2. Robbins HA, Pfeiffer RM, Shiels MS, et al. Excess cancers among HIV-infected people in the United States. J Natl Cancer Inst. 2015;107(4). pii: dju503. doi: 10.1093/jnci/dju503. Print 2015 Apr