Before initiating ART, which factor should a nurse assess in an HIV-infected patient with a CD4+ cell count of 400/µL?

When pursuing antiretroviral therapy (ART) for an HIV-infected patient, particularly one with a CD4+ cell count of 400/µL, it's crucial to assess the patient's ability to comply with the ART schedule. This factor is essential because adherence to the prescribed treatment regimen is pivotal for achieving viral suppression, improving immune function, and preventing the development of drug resistance.

If a patient cannot follow the ART regimen consistently, they may not only face treatment failure but also contribute to continued viral replication and potential transmission of the virus to others. Therefore, evaluating the patient's capability to adhere to the treatment timetable—considering their lifestyle, commitment, and any potential barriers—is fundamental in ensuring the effectiveness of the therapy initiated.

A supplementary assessment of social support systems could also contribute positively to treatment adherence, but compliance specifically addresses the ability to follow the prescribed ART regimen, which is directly linked to the success of the treatment. Similarly, while knowledge of potential medication side effects and HIV genotype may inform treatment options, the most immediate concern prior to initiating ART remains understanding the patient's commitment to following the treatment plan.