What is the role of prophylaxis against protozoal and helminthic 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

Patients infected with HIV are at risk for infections with Cryptosporidium species, Giardia species, Isospora species, Cyclosporaspecies, and Microsporidia species, as well as Entamoeba species and Strongyloidiasis species in some locales and with exposure to animals, especially animals with diarrhea. Neither primary nor secondary prophylaxis is indicated. Concomitant malaria and HIV disease is a major problem in Africa, but trimethoprim-sulfamethoxazole may have some prophylactic benefit. [24]

Patients with risk factors for Chagas disease and who are seropositive for Trypanosoma cruzi who have not been previously treated and do not have advanced cardiomyopathy can be considered for a course of either benznidazole or nifurtimox, but efficacy is suboptimal (CIII recommendation), while prompt ART therapy may prevent reactivation of parasitic disease (BIII recommendation). [24]


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