TY  - CHAP
M1  - Book, Section
TI  - Opportunistic Infections
A1  - Clay, Patrick G.
A2  - Sutton, S. Scott
PY  - 2020
T2  - McGraw Hill’s NAPLEX® Review Guide, 4e
AB  - Persons  with  human  immunodeficiency  virus  (HIV)  have  weakened  immune  systems  and  are  at  risk  for  opportunistic  infections  (OIs).  OIs  are  caused  by  organisms  that  are  common  in  the  environment  and  may  represent  reactivation  of  a  suppressed/hidden  infection.  OIs  risk  increases  as  CD4  counts  decrease  (Figure  28-1).  The  CD4  count  serves  as  the  basis  for  initiating  or  discontinuing  OI  therapy.  In  the  antiretroviral  era,  the  main  principle  in  OI  management  is  treating  HIV  with  antiretrovirals  to  enable  CD4  cell  recovery.  Additional  OI  management  is  classified  based  on  the  intended  goal:  (1)  primary  prophylaxis  (reduces  the  likelihood  for  first  occurrence),  (2)  treatment  (resolves  an  active  infection),  and  (3)  secondary  prophylaxis/chronic  maintenance  suppressive  therapy  (prevents  a  prior  infection  from  returning).  Importantly,  the  pathogen  determines  the  therapy  and  the  management  goal  determines  the  dose,  frequency,  and  duration.  An  example  treatment  plan  for  select  OIs  in  a  person  living  with  HIV  includes  (may  vary  pending  the  specific  OI):  (1)  management  of  HIV  with  antiretrovirals  (eg,  dolutegravir,  abacavir,  and  lamivudine);  (2)  prevent  exposure  to  opportunistic  pathogens;  (3)  use  primary  chemoprophylaxis  at  certain  CD4  thresholds  to  prevent  first-episode  disease;  (4)  treat  OI;  (5)  use  secondary  chemoprophylaxis  to  prevent  disease  recurrence;  and  (6)  discontinue  prophylaxis  with  sustained  CD4  recovery  from  utilization  of  antiretrovirals.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1179734316
ER  -