Opportunistic infections in HIV: Difference between revisions
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== Prophylaxis regimens == |
== Prophylaxis regimens == |
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* ''Pneumocystis jirovecii'' (CD4 <200) |
* ''[[Pneumocystis jirovecii]]'' (CD4 <200) |
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** Preferred: TMP-SMX 1 DS or SS PO daily |
** Preferred: TMP-SMX 1 DS or SS PO daily |
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** Alternate |
** Alternate |
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*** Pentamidine nebs 300 mg every month |
*** Pentamidine nebs 300 mg every month |
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*** Atovaquone 1500 mg PO daily |
*** Atovaquone 1500 mg PO daily |
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* ''Toxoplasma gondii'' (CD4 <100 and IgG positive) |
* ''[[Toxoplasma gondii]]'' (CD4 <100 and IgG positive) |
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** Preferred: TMP-SMX 1 DS PO daily |
** Preferred: TMP-SMX 1 DS PO daily |
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** Alternate |
** Alternate |
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*** Dapsone 50 mg PO daily + pyrimethamine/leucovorin PO weekly |
*** Dapsone 50 mg PO daily + pyrimethamine/leucovorin PO weekly |
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*** Atovaquone 1500 mg PO daily |
*** Atovaquone 1500 mg PO daily |
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* ''Mycobacterium avium complex'' (CD4 <50) |
* ''[[Mycobacterium avium complex]]'' (CD4 <50) |
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** Preferred: Azithromycin 1200 mg PO once weekly |
** Preferred: Azithromycin 1200 mg PO once weekly |
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** Alternate |
** Alternate |
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Revision as of 22:35, 15 September 2019
| CD4 | Infections | Action |
|---|---|---|
| Any | Tuberculosis | Screen for latent tuberculosis Vaccinate for pneumococcus, influenza, varicella, HPV (if appropriate), Hepatitis A, and Hepatitis B |
| <500 | Kaposi sarcoma (HHV-8) Herpes simplex Varicella zoster |
|
| <300 | Candida Molluscum contagiosum Diarrhea from microsporidia and cryptosporidia |
|
| <200 | Pneumocystis jirovecii pneumonia Dimorphic fungi |
Start PJP prophylaxis (Septra SS or DS) |
| <100 | Toxoplasmosis Cryptococcus |
Start toxo prophylaxis if IgG positive (Septra DS) |
| <50 | Mycobacterium avium complex Cytomegalovirus, including retinitis Progressive multifocal leukoencephalopathy (PML) from JC virus |
Start MAC prophylaxis (azithromycin) |
Prophylaxis regimens
- Pneumocystis jirovecii (CD4 <200)
- Preferred: TMP-SMX 1 DS or SS PO daily
- Alternate
- TMP-SMX 1 DS PO three times weekly
- Dapsone 100 mg PO daily or 50 mg PO BID
- Pentamidine nebs 300 mg every month
- Atovaquone 1500 mg PO daily
- Toxoplasma gondii (CD4 <100 and IgG positive)
- Preferred: TMP-SMX 1 DS PO daily
- Alternate
- TMP-SMX 1 DS PO three times weekly
- TMP-SMX 1 SS PO daily
- Dapsone 50 mg PO daily + pyrimethamine/leucovorin PO weekly
- Atovaquone 1500 mg PO daily
- Mycobacterium avium complex (CD4 <50)
- Preferred: Azithromycin 1200 mg PO once weekly
- Alternate
- Clarithromycin 500 mg PO BID
- Azithromycin 600 mg PO twice weekly
- Rifabutin, dose-adjusted to HIV meds
