What are risks 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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Answer

Answer

Prior to initiation of prophylaxis, the clinician should attempt to clinically exclude active disease, as the prophylactic regimen may not sufficiently treat an active infection or may even mask signs of infection. In most cases, obtaining a thorough history and conducting an examination with symptom-targeted laboratory and radiologic tests are enough to exclude active P carinii pneumonia (PCP), M avium complex (MAC) infection, and tuberculosis. Increasingly, serum cryptococcal antigen testing is used to screen at-risk patients for early disease, particularly in Africa. [31, 32]


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