What are the clinical landmarks for terminating 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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After ART is initiated and HIV viremia is suppressed, PCP and toxoplasmosis prophylaxis should  continue until the CD4 count exceeds 200 cells/μL for 3 months (AI recommendation) or 100 to 200 cells/uL with negative HIV viral load for 6 months (BII recommendation). Histoplasmosis prophylaxis can be discontinued when the CD4 count has exceeded 150 cells/μL for 6 months (BIII recommendation); coccidioidomycosis prophylaxis can be stopped when CD4 counts exceed 250 cells/μL for 6 months (CIII recommendation); and penicilliosis prophylaxis can be discontinued when CD4 counts exceed 100 cells/μL for 6 months (BII recommendation). [1]

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