Updated Guidelines for Prevention and Treatment of Opportunistic Infections in HIV Positive Adults, Adolescents, and Children

The National Institutes of Health, Centers for Disease Control and Prevention (CDC), and the HIV Medicine Association of the Infectious Diseases Society of America recently released update guidelines for the prevention and treatment of opportunistic infections (OIs) in adult, adolescents, and children with HIV.

Major changes to the Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, updated on June 18, include a greater emphasis on the importance of antiretroviral therapy for prevention and treatment of OIs; this is especially important in the case of OIs for which there is no effective treatment.

A study presented at the 15th Conference on Retroviruses and Opportunistic Infections this past February showed that delaying antiretroviral therapy for even several weeks while starting OI treatment was associated with a higher risk of AIDS progression or death compared with immediate HAART.

The revised guidelines also include new information on interferon-gamma release assays for detection of latent tuberculosis (TB) and updates on drug interactions involving rifamycin for TB prevention and treatment.

Other changes include expanded information on diagnosis and management of immune reconstitution inflammatory syndromes (IRIS), as well as new sections on hepatitis B virus (HBV) coinfection and malaria.

The Guidelines for Prevention and Treatment of Opportunistic Infections among HIV-Exposed and HIV-Infected Children, with input from the Pediatric Infectious Diseases Society, were updates on June 20.

Both documents are available online at www.aidsinfo.nih.gov/Guidelines. They have been submitted for publication in the CDC's Morbidity and Mortality Weekly Report and should be considered final drafts. Upon acceptance and publication, the drafts will be replaced with the published versions.

7/08/08

Sources

National Institutes of Health, Centers for Disease Control and Prevention, and HIV Medicine Association of the Infectious Diseases Society of America. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. June 18, 2008.

Centers for Disease Control and Prevention, National Institutes of Health, HIV Medicine Association of the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society. Guidelines for Prevention and Treatment of Opportunistic Infections among HIV-Exposed and HIV-Infected Children. June 20, 2008.