HIV AIDS opportunistic infections
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Before the widespread use of potent combination antiretroviral therapy (ART), opportunistic infections (OIs), which have been defined as infections that are more frequent or more severe because of immunosuppression in HIV-infected persons, were the principal cause of morbidity and mortality in this population. In the early 1990s, the use of chemoprophylaxis, immunization, and better strategies for managing acute OIs contributed to improved quality of life and improved survival.[1] However, the widespread use of ART starting in the mid-1990s has had the most profound influence on reducing OI-related mortality in HIV-infected persons in those countries in which these therapies are accessible and affordable.
HIV Opportunistic Infections
Bacteria
| Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
|---|---|---|---|---|---|
| Mycobacterium tuberculosis | |||||
| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] | |||||
Virus
| Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
|---|---|---|---|---|---|
| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] | |||||
Fungus
| Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
|---|---|---|---|---|---|
| Pneumocystis Pneumonia (Click here for more information) |
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Subacute onset of progressive dyspnea, fever, nonproductive cough, and chest discomfort that worsens within days to weeks. Tachypnea, tachycardia, and diffuse dry rales are found in the physical examination. | Clinical presentation, blood tests, or chest x-rays are not pathognomonic for PCP. | Start TMP-SMX prophylaxis when CD4+ <200 cells/µL or history of oropharyngeal candidiasis. Discontinue prophylaxis when CD4+ is >200 cells/µL for >3 month. |
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| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] | |||||
Parasite
| Disease | Description | Clinical Findings | Diagnosis | Prophylaxis | Treatment |
|---|---|---|---|---|---|
| Toxoplasma gondii Encephalitis (Click here for more information) |
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Focal encephalitis with headache, confusion, or motor weakness and fever | Diagnosis is done with IgG antibodies. CT scan or MRI of the brain will typically show multiple contrast-enhancing lesions, often with associated edema. Definite diagnosis requires a brain biopsy. | Start TMP-SMX prophylaxis when CD4+ <100 cells/µL Discontinue prophylaxis when CD4+ is >200 cells/µL for >3 month. |
Administer:
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| Cryptosporidiosis (Click here for more information) |
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| Microsporidiosis | |||||
| Table adapted from Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents [2] | |||||
References
- ↑ Walensky RP, Paltiel AD, Losina E, Mercincavage LM, Schackman BR, Sax PE, Weinstein MC, Freedberg KA (2006). "The survival benefits of AIDS treatment in the United States". J. Infect. Dis. 194 (1): 11–9. doi:10.1086/505147. PMID 16741877. Retrieved 2012-04-05. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 2.2 2.3 "Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents".