- Section 2: Testing and Assessment
- Initial History
- Initial Physical Examination
- Initial and Interim Laboratory and Other Tests
- Interim History and Physical Examination
- HIV Classification: CDC and WHO Staging Systems
- CD4 and Viral Load Monitoring
- Risk of HIV Progression/Indications for ART
- Early HIV Infection
- Expedited HIV Testing
- Resistance Testing
- Karnofsky Performance Scale
- Occupational Postexposure Prophylaxis
- Nonoccupational Postexposure Prophylaxis
- Preventing HIV Transmission/Prevention with Positives
- Immunizations for HIV-Infected Adults and Adolescents
- Preventing Exposure to Opportunistic and Other Infections
- Opportunistic Infection Prophylaxis
- Latent Tuberculosis Infection
- Smoking Cessation
- Abnormalities of Body-Fat Distribution
- Insulin Resistance, Hyperglycemia, and Diabetes on Antiretroviral Therapy
- Coronary Heart Disease Risk
- Renal Disease
- Immune Reconstitution Inflammatory Syndrome
- Anal Dysplasia
- Candidiasis, Oral and Esophageal
- Candidiasis, Vulvovaginal
- Cervical Dysplasia
- Cryptococcal Disease
- Cytomegalovirus Disease
- Gonorrhea and Chlamydia
- Hepatitis B Infection
- Hepatitis C Infection
- Herpes Simplex, Mucocutaneous
- Herpes Zoster/Shingles
- Kaposi Sarcoma
- Molluscum Contagiosum
- Mycobacterium avium Complex Disease
- Mycobacterium tuberculosis
- Pelvic Inflammatory Disease
- Pneumocystis Pneumonia
- Progressive Multifocal Leukoencephalopathy
- Seborrheic Dermatitis
Preventing Exposure to Opportunistic and Other Infections
Publish date: April 2014
Persons with HIV infection are more susceptible than others to certain infections. HIV-infected persons may come into contact with opportunistic pathogens in the course of various aspects of their daily activities. Pets, children, personal and sexual contacts, and food and water, as well as involvement in occupational tasks, recreation, hobbies, and other activities all potentially can expose an HIV-infected person to opportunistic pathogens, some of which are ubiquitous and cannot be avoided. Among the ubiquitous pathogens are Candida, Mycobacterium avium, Pneumocystis jiroveci, and human herpesvirus 6 and 7. Exposure to other opportunistic pathogens may be minimized if patients are aware of the risks.
The following tables group opportunistic pathogens by type of exposure. Mechanisms of transmission and recommendations for avoidance are outlined. Note that a number of infections can be transmitted by several of these modes.
For information about vaccinations, see chapter Immunizations for HIV-Infected Adults and Adolescents; for opportunistic infection (OI) prophylaxis, see chapter Opportunistic Infection Prophylaxis.
- Water related
- Food associated
- Respiratory and bodily contact
- Associated with sexual contact
- Injection drug use associated
- Other bloodborne related
- Pet and animal related
- Contact with children
- Travel related
|Mechanisms of Transmission||Details and Recommendations for Avoidance|
|Recommended avoidance measures|
|Recommended avoidance measures|
Other geographically specific opportunistic infections include visceral leishmaniasis, Penicillium marneffei infection, coccidiomycosis, histoplasmosis, and TB.
- Aberg JA, Gallant JE, Ghanem KG, et al.; HIV Medicine Association of the Infectious Diseases Society of America. Primary Care Guidelines for the Management of Persons Infected With HIV: 2013 Update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014 Jan;58(1):e1-e34.
- Centers for Disease Control and Prevention. Preventing Infections from Pets. CDC Brochures for Persons Living with HIV/AIDS. Accessed December 1, 2013.
- Centers for Disease Control and Prevention. Health Information for International Travel 2012. Atlanta: U.S. Department of Health and Human Services, Public Health Service; 2012. Chapter 8. The Immunocompromised Traveler.Accessed December 1, 2013.
- Gordon RJ, Lowy FD. Bacterial infections in drug users. N Engl J Med. 2005 Nov 3;353(18):1945-54.
- Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Accessed December 1, 2013.
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Abbreviations for Dosing Terminology
- twice daily
- twice weekly
- intramuscular (injection), intramuscularly
- intravenous (injection), intravenously
- oral, orally
- Q2H, Q4H, etc.
- every 2 hours, every 4 hours, etc.
- every morning
- once daily
- every hour
- every night at bedtime
- four times daily
- every other day
- every evening
- three times daily
- three times weekly