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GUIDELINES FOR USING ANTIRETROVIRAL AGENTS AND PREVENTING OPPORTUNISTIC INFECTIONS AMONG HIV-INFECTED PERSONS

Guidelines for Preventing Opportunistic Infections among HIV-Infected Persons—2002: Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America*

Prepared by Henry Masur, MD; Jonathan E. Kaplan, MD; and King K. Holmes, MD, PhD

3 September 2002 | Volume 137 Issue 5 Part 2 | Pages 435-478

Summary: In 1995, the U.S. Public Health Service (USPHS) and the Infectious Diseases Society of America (IDSA) developed guidelines for preventing opportunistic infections (OIs) among persons infected with human immunodeficiency virus (HIV); these guidelines were updated in 1997 and 1999. This fourth edition of the guidelines, made available on the Internet in 2001, is intended for clinicians and other health-care providers who care for HIV-infected persons. The goal of these guidelines is to provide evidence-based guidelines for preventing OIs among HIV-infected adults and adolescents, including pregnant women, and HIV-exposed or infected children. Nineteen OIs, or groups of OIs, are addressed, and recommendations are included for preventing exposure to opportunistic pathogens, preventing first episodes of disease by chemoprophylaxis or vaccination (primary prophylaxis), and preventing disease recurrence [secondary prophylaxis]. Major changes since the last edition of the guidelines include 1) updated recommendations for discontinuing primary and secondary OI prophylaxis among persons whose CD4⁺ T lymphocyte counts have increased in response to antiretroviral therapy; 2) emphasis on screening all HIV-infected persons for infection with hepatitis C virus; 3) new information regarding transmission of human herpesvirus 8 infection; 4) new information regarding drug interactions, chiefly related to rifamycins and antiretroviral drugs; and 5) revised recommendations for immunizing HIV-infected adults and adolescents and HIV-exposed or infected children.

Author and Article Information

The material in this report was prepared for publication by the National Center for HIV, STD, and TB Prevention, Harold W. Jaffe, MD, Acting Director, the Division of HIV/AIDS Prevention—Surveillance and Epidemiology, Robert S. Janssen, MD, Director; and the National Center for Infectious Diseases, James M. Hughes, MD, Director.

This document was originally published in MMWR on 14 June 2002 (RR81).

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