A 28-year-old woman with HIV (CD4 220 cells/µL) on first-line ART (TDF/FTC/EFV) for 6 months presents with fever, headache, and neck stiffness. CSF analysis shows: glucose 35 mg/dL (serum 100), protein 180 mg/dL, WBC 85 (60% lymphocytes), India ink stain negative, bacterial culture negative. Which of the following is NOT a recognized feature or management principle of her presumed diagnosis?