Immunosuppression that results from HIV infection significantly increases the risk for acquiring opportunistic bacterial, viral, fungal, and protozoan infections. These opportunistic infections are a major cause of morbidity and mortality in the HIV population. For this patient with a CD4+ cell count of 10 cells/µL, prophylaxis should have included TMP/SMX and azithromycin for prevention of PCP, toxoplasmosis, and M. avium complex (Table).3 Fluconazole is effective for preventing cryptococcal infection in patients with a CD4+ cell count less than 50 cells/µL, but it is not routinely recommended. Additionally, fluconazole is only recommended for the prevention of Candida infection if the patient has had frequent or severe recurrences.
- TMP/SMX and azithromycin.
3. Kaplan JE, Masur H, Holmes KK. Guidelines for the prevention of opportunistic infections among HIV-infected persons—2002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. Available at http://aidsinfo.nih.gov/contentfiles/OIpreventionGL.pdf. Accessed 5 May 2008.
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