Infectious Disease 4: Opportunistic Infections

Question 1

Common infections requiring primary prophylaxis

Answer 1

Pneumocystis pneumonia (PCP or PJP)
Toxoplasmosis gondii encepthalitis
Mycobacterium avium complex (MAC)

Question 2

Indication and regimen for PCP primary prophylaxis

Answer 2

<200 cells/mm3
SMX/TMP daily
or
dapsone
dapsone + pyrimethamine + leucovorin
atovaquone

Question 3

Indication and regimen for Toxo primary prophylaxis

Answer 3

<100 cells/mm3
SMX/TMP 
or
dapsone + pyrimethamine + leucovorin
atovaquone

Question 4

When to discontinue PCP and Toxo prophylaxis

Answer 4

CD4+ count >/= 200 cells/mm3 for >/= 3 months on ART

Question 5

Indication, regimen and discontinuation for MAC primary prophylaxis

Answer 5

Initiate if NOT taking ART and CD4+ < 50 cells/mm3
azthromycin 1200 mg PO weekly
discontinue once taking fully suppressive ART