Human Immunodeficiency Virus Book

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Prevention of Secondary Infection in HIV

Aka: Prevention of Secondary Infection in HIV, HIV Prophylaxis of Secondary Infection
  1. 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)
  2. Immunizations
    1. See Immunization in HIV
  3. 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
  4. References
    1. Kaplan (2002) MMWR Recomm Rep 51:1-52 [PubMed]
    2. Kaplan (2009) MMWR Recomm Rep 58(RR-4): 1-207 [PubMed]

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