Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents
Published Date: 04/10/2009
Source: U.S. Centers for Disease Control and Prevention; Infectious Disease Society of America and nih
Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents PDF [2.5MB]
Slide sets to accompany the guidelines are available from the National Resource Center.
Overview of Content and Changes
"These guidelines provide recommendations for diagnosis and treatment of 30 opportunistic infections commonly occurring in people infected with HIV. The 2009 update combines treatment and prevention recommendations for the first time. Other new features include:
(1) more emphasis on the importance of ART for prevention and treatment of OIs, especially those for which specific chemoprophylaxis and treatment do not exist;
(2) information on diagnosis and management of immune reconstitution inflammatory syndromes (IRIS);
(3) information on interferon-gamma release assays (IGRAs) for the detection of latent Mycobacterium tuberculosis infection; (4) updated information on drug interactions affecting use of rifamycin drugs for prevention and treatment of tuberculosis (TB); (5) the addition of a section on hepatitis B virus (HBV) infection; and (6) the addition of a section on malaria to the OIs of geographic interest.
"For each of the OIs covered in this report, recommendations are provided that address: (1) preventing exposure to opportunistic pathogens, (2) preventing disease, (3) discontinuing primary prophylaxis after immune reconstitution, (4) treatment of disease, (5) monitoring for adverse effects (including IRIS), (6) management of treatment failure, (7) preventing disease recurrence ("secondary prophylaxis" or chronic maintenance therapy), (8) discontinuing secondary prophylaxis after immune reconstitution, and (9) special considerations during pregnancy. In disease-specific sections of the document, the guidelines includes nine tables pertinent to the prevention and treatment of OIs (Tables 1-9), a figure that includes immunization recommendations (Fig. 2), and an appendix that summarizes recommendations pertinent to prevention of exposure to opportunistic pathogens."
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