DOWNLOAD: Opportunistic Infection Therapeutic Guidelines
Despite the reduction in the incidence of HIV-related opportunistic infections since the introduction of highly active antiretroviral therapy (HAART) in 1996, significant numbers of patients continue to present with advanced HIV disease and the full spectrum of opportunistic infections associated with severe CD4 lymphopenia. These infections occur more often in marginalized patient populations who are not engaged in antiretroviral therapy and other preventive measures, such as vaccination programs and opportunistic infection prophylaxis.
Recent changes with respect to opportunistic prophylaxis and treatment include the immune reconstitution inflammatory syndromes (IRIS), which may occur in approximately 25% of patients who begin HAART in the setting of advanced HIV disease and CD4 counts below 100 cells/mcL. Criteria for discontinuing opportunistic infection prophylaxis have also been established for patients who experienced antiretroviral-therapy-induced immune reconstitution.
