What is the role of CD4 counts in the selection of antimicrobial prophylaxis for the prevention of opportunistic infections in patients with HIV infection?

Updated: Mar 09, 2021
  • Author: Justin R Hofmann, MD; Chief Editor: John Bartlett, MD  more...
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The following CD4 counts are useful landmarks for initiation of antimicrobial prophylaxis [1, 2] :

Less than 250 cells/μL - Coccidioidomycosis prophylaxis if seropositive in high-risk area

Less than 200 cells/μL - PCP prophylaxis

Less than 150 cells/μL - Histoplasmosis prophylaxis if exposure to hyperendemic areas

Less than 100 cells/μL - Toxoplasmosis prophylaxis (if seropositive)

Less than 100 cells/uL - Cryptococcosis preemptive therapy if antigen-positive

Less than 100 cells/μL - Penicilliosis prophylaxis if living in high-risk area

Less than 50 cells/μL - M avium complex (MAC) infection prophylaxis unless ART is immediately initiated [1]

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