What is the primary prophylaxis against toxoplasma gondii infection 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

Patients with a CD4 count below 100 cells/μL who are not previously known to be seronegative for toxoplasma immunoglobulin G (IgG) should receive prophylaxis for toxoplasmosis. Trimethoprim-sulfamethoxazole, 1 double-strength tablet orally once daily is preferred (AII recommendation). Dapsone alone is ineffective against toxoplasmosis. Therefore, dapsone 50 mg orally daily plus pyrimethamine 50 mg orally weekly plus leucovorin 25 mg orally weekly is appropriate for both PCP and toxoplasmosis (BI recommendation). Alternatively, atovaquone with or without pyrimethamine/leucovorin can be considered. [1]


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