What condition is indicated by CD4 count less than 200 alongside severe peripheral edema and frothy urine?

A CD4 count of less than 200 is indicative of severe immunocompromise, often associated with advanced HIV infection leading to AIDS. In this context, the presence of severe peripheral edema and frothy urine suggests a nephrotic syndrome, which is characterized by significant proteinuria, hypoalbuminemia, and edema.

Focal Segmental Glomerulosclerosis (FSGS) is a condition that fittingly explains these symptoms in a patient with low CD4 counts. This kidney disorder involves the scarring of some segments of the glomeruli, the filtering units of the kidneys, leading to a loss of protein into the urine, hence the frothy urine character. The significant protein loss causes low serum albumin levels, which contributes to the development of edema, including severe peripheral edema.

Given the patient's immunocompromised status and the associated kidney symptoms, FSGS is a common renal manifestation in individuals with HIV/AIDS, making it the most appropriate diagnosis given the combination of lab findings and clinical presentation. Other conditions listed may be associated with kidney problems but do not typically present with the combination of such prominent signs in an immunocompromised individual.