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Prevention of Secondary Infection in HIV

Aka: Prevention of Secondary Infection in HIV, HIV Prophylaxis of Secondary Infection

Management: General Strategies to avoid secondary infections
1. Always use Condoms
2. Avoid oral-to-anal sex
3. Sterile technique for tattoos, piercings, IVDA
4. Avoid raw eggs or fish, unpasterized juices or milk
  1. See Foodborne Illness Prevention
5. Avoid higher risk environments for secondary infection
  1. Work at homeless shelters, day care centers, prisons
  2. Exposure to animal feces (cat, bat)
Immunizations
1. See Immunization in HIV
Management: Antibiotic Prophylaxis
1. CD4 Count <200/mm3 or Thrush: Pneumocystis prophylaxis
  1. Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim, Septra) DS or
  2. Alternatives: Dapsone daily (if G6PD negative) or Atovaquone have also been used
2. CD4 Count <100/mm3 or Toxoplasma IgG positive: Toxoplasmosis prophylaxis
  1. Trimethoprim-sulfamethoxazole (TMP-SMZ, Bactrim, Septra) DS daily
3. CD4 Count <50/mm3: Mycobacterium Avium Intracellulare (MAI)
  1. Azithromycin 1200 mg orally weekly (preferred)
  2. Alternative: Clarithromycin 500 mg orally twice daily has also been used
References
1. Kaplan (2002) MMWR Recomm Rep 51:1-52
2. Kaplan (2009) MMWR Recomm Rep 58(RR-4): 1-207

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 12/25/2011 and last published on 5/14/2013.

This is one of 5887 pages in the Family Practice Notebook