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Primary Prevention of Opportunistic Infections
* For PCP, may discontinue primary or secondary prophylaxis if CD4 count>200 for 3 months
* For toxoplasmosis, may discontinue primary prophylaxis when CD4>200 for >3 months. Less data on discontinuation of secondary prophylaxis, but when initial treatment for toxoplasmosis is completed and CD4>200 for >6 month it appears safe to discontinue secondary prophylaxis (some advocate MRI prior to discontinuation of secondary prophylaxis).
* For MAC may discontinue primary prophylaxis when CD4>100 for >3 months. Less data on discontinuation of chronic maintenance therapy, but if patient has received >12 months of treatment for MAC, remains asymptomatic, and has had a >6 months of a CD4 count >100, it appears safe to discontinue therapy. (Some experts recommend checking MAC blood cultures prior to discontinuation; some report increase chance of relapse in osteomyelitis secondary to MAC)
For more details on prevention and treatment of opportunistic infections see the link to the Department of Health and Human Services on this webpage or go directly to:
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