Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents

What's New in the Guidelines

Updates to the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents

The Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV Infected Adults and Adolescents document was published in an electronic format that could be easily updated as relevant changes in prevention and treatment recommendations occur.

The editors and subject matter experts are committed to timely changes in this document because so many health care providers, patients, and policy experts rely on this source for vital clinical information.

All changes are developed by the subject matter groups listed in the document (changes in group composition are also promptly posted). These changes are reviewed by the editors and by relevant outside reviewers before the document is altered. Major revisions within the last 6 months are as follows:

February 21, 2018

  1. Human Herpesvirus-8: The epidemiology of HHV-8 infection and HHV-8 related malignancies has been revised to reflect current data, and information about the newly described clinical syndrome, the KSHV inflammatory cytokine syndrome (KICS), is provided. Treatment recommendations for multicentric Castleman's disease have been updated.

October 18, 2017

  1. Candida: This section was updated a) to include isavuconazole as a treatment option for patients with uncomplicated esophageal candidiasis, b) to highlight the results of a study describing complications from fluconazole use during pregnancy, and c) to incorporate statements regarding the occurrence of infections by non-albicans Candida strains, the presence of drug-drug interactions and absorption considerations with posaconazole, and the importance of ART/immune restoration in preventing mucosal candidiasis.

August 10, 2017

  1. Bacterial Enteric Infections: This revision highlights new data from the CDC Health Advisory Network (April, 2017) indicating growing concern over fluoroquinolone resistant in Shigella isolates. Fluoroquinolones should only be used to treated Shigella isolates when the MIC<0.12 μg/ml. Reflex cultures of stools positive for Shigella spp. by culture-independent diagnostic tests is required for antibiotic sensitivity testing.

August 3, 2017

  1. Hepatitis B Virus: This section was updated to include TAF/FTC as a treatment option for patients with HBV/HIV coinfection. Data on the virologic efficacy of TAF for the treatment of HBV in persons without HIV infection and TAF/FTC in persons with HBV/HIV coinfection are discussed.

    The Panel no longer recommends adefovir or telbivudine as options for HBV/HIV coinfected patients, as there is limited safety and efficacy data on their use in this population. In addition, these agents have a higher incidence of toxicities than other recommended treatments.

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