Opportunistic Infections of HIV
Certain bacteria, viruses, fungi, and protozoa which do not usually cause infections in healthy people, can cause infections in people with a weakened immune system; these are called opportunistic infections.
Classification of opportunistic infection in HIV/AIDS
Bacterial and mycobacterial infections
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Mycobacterium Avium Complex
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Salmonellosis
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Syphilis and Neuroshyphilis
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Tuberculosis
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Bacillary angiomatosis
Fungal infections
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Aspergillosis
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Candidiasis (thrush)
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Coccidioidomycosis
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Cryptococcal Meningitis
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Histoplasmosis
Viral infections
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Cytomegalovirus (CMV)
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Hepatitis
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Herpes Simplex (HSV, genital herpes)
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Herpes Zoster (HZV, shingles)
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Human Papiloma Virus (HPV, genital warts, cervical cancer)
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Molluscum Contagiosum
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Oral Hairy Leukoplakia (OHL)
Protozoal infections
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Cryptosporidiosis
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Isosporiasis
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Pneumocystis Carinii Pneumonia (PCP)
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Toxoplasmosis
Other complications
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AIDS dementia complex
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Apthous ulcers
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Malabsorption
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Peripheral neuropathy
HIV associated malignancy
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Kaposi sarcoma
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Lymphoma
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Squamous cell carcinoma
Prevention of HIV related opportunistic infections
Prophylaxis against opportunistic infections in patients with AIDS
|
Infection |
Drug used |
Indications |
|
Pneumocystis carinii pneumonia (PCP) |
Trimethoprim-sulfamethaxazole- DS (cotrimoxazole) |
CD4 count <200 cells thrush; unexplained fever for more than two weeks; history of PCP |
|
Toxoplasmosis |
Trimethoprim-sulfamethaxazole(double-strength) |
CD4 count <100 cells and Toxoplasma sero-positive |
|
Mycobacterium avium complex |
Azithromycin |
CD4 count <50 cells |
|
Histoplasmosis |
Itraconazole |
CD4 count <100 cells and lives in an endemic area |
Discontinuation of preventive treatment
-
Preventive treatment for mycobacterium avium complex infection is usually discontinued when the T cell count is >100 cells/µL for 3 months.
-
Preventive treatment for pneumocystis and toxoplasmosis is usually discontinued when the T cell count is >200 cells/µL for 3 months.
The World Health Organization (WHO) recommends that, in resource-limited settings, the following groups of people should begin taking cotrimoxazole:
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HIV-exposed infants/children, starting at 4-6 weeks after birth or at first contact with health care, and continued until HIV infection is excluded
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HIV-positive children less than 1 year old
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HIV-positive children aged 1-4 years who have mild, advanced or severe symptoms of HIV disease, or a CD4 count below 25%
-
HIV-positive adults and adolescents who have mild, advanced or severe symptoms of HIV disease, or a CD4 count below 350 cells per ml
-
HIV-positive people with a history of treated PCP.
