Opportunistic Infections

Question 1

Treatment Initiation

Answer 1

Prophylactically
On-going to prevent active infection
Preemptively in pts with antigen tests who are asymptomatic

Question 2

CD4 Cutoffs for Opportunistic Infections

Answer 2

All in cells/microliter
Cocciodiomycosis: 250
Pneumocystis: 200
Histoplasmosis: 150
Toxoplasma/Cryptococcus: 100
Mycobacterium Avium Complex (MAC): 50

Question 3

Pneumocystis Pneumonia (PCP)

Answer 3

Drug of choice: Sulfamethaxazole/Trimethroprim (Bactrim)

Question 4

Toxoplasmosis

Answer 4

Drug of Choice: Sulfadiazine + Pyrimethamine + Leucovorin
Prophylaxis: Sulfamethoxazole/Trimethoprim (Bactrim)

Question 5

Cryptococcal Meningitis

Answer 5

DoC: Amphotericin B
Secondary prevention: Fluconazole indefinitely
NO preventative therapy

Question 6

Cytomegalovirus (CMV)

Answer 6

DoC: (antiviral agents) Ganciclovir, Valganciclovir, Cidofovir, Foscarnet

Question 7

TB and MAC

Answer 7

DoC: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
MAC: Not treated prophylactically

Question 8

Varicella Zoster (Shingles)

Answer 8

DoC: Valacyclovir or Famiciclovir orally OR IV Acyclovir for extensive cases

Question 9

Herpes Simplex

Answer 9

Oral Treatment: Acyclovir, Fam, Val
Widespread: IV Acyclovir or Foscarnet