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ID Board Review/Human Immunodeficiency Virus (HIV) Infection/Complications of HIV/Opportunistic Infections (OIs)/OI Prevention

< ID Board Review‎ | Human Immunodeficiency Virus (HIV) Infection‎ | Complications of HIV‎ | Opportunistic Infections (OIs)
Opportunistic Infection Prophylaxis: CD4 Levels and Other Indications
Infection CD4 Count, or Other Indications Prophylaxis
PJP
  • CD4 <200
  • OR Oropharyngeal Candidiasis
  • OR Hx of PCP Infx
  • TMP/SMX
  • ALT: Dapsone, Atovaquone, or Pentamidine
Toxoplasma gondii
  • CD4 <100 AND +IgG Ab
  • TMP/SMX
  • ALT: Dapsone + Pyrimethamine + Leucovorin
  • ALT: Atovaquone +/- Pyrimethamine + Leucovorin
Histoplasma capsulatum
  • CD4 <150 AND living in endemic areas
  • Intraconazole
VZV
  • Close clontact w Chickenpox, or Shingles AND...
  • No Hx of prior Dz, OR negative VZV Abs
  • VariZIG OR IVIG (w/n 4 d of exposure)

Note

  • It is no longer recommended to provide prophylaxis for Mycobacterium avium complex (MAC)
    • MAC was previously covered when CD4 was < 50, however, this ppx was stopped due to risk of macrolide-resistance, and low incidence of MAC
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