Prevention of opportunistic infections in adult and adolescent patients with HIV infection. GESIDA/National AIDS Plan guidelines, 2004 [correction].
OBJECTIVE
To provide an update of guidelines from the Spanish AIDS Study Group (GESIDA) and the National AIDS Plan (PNS) committee on the prevention of opportunistic infections in adult and adolescent HIV-infected patients.


METHODS
These consensus recommendations have been produced by a group of experts from GESIDA and/or the PNS after reviewing the earlier document and the scientific advances in this field in the last years. The system used by the Infectious Diseases Society of America and the United States Public Health Service has been used to classify the strength and quality of the data.


RESULTS
This document provides a detailed review of the measures for the prevention of infections caused by viruses, bacteria, fungi and parasites in the context of HIV infection. Recommendations are given for preventing exposure and for primary and secondary prophylaxis for each group of pathogens. In addition, criteria are established for the withdrawal of prophylaxis in patients who respond well to highly active antiretroviral therapy (HAART).


CONCLUSIONS
HAART is the best strategy for the prevention of opportunistic infections in HIV-positive patients. Nevertheless, prophylaxis is still necessary in countries with limited economic resources, in highly immunodepressed patients until HAART achieves beneficial effects, in patients who refuse to take or who cannot take HAART, in those in whom HAART is not effective, and in the small group of infected patients with inadequate recovery of CD4+ T lymphocyte counts despite good inhibition of HIV replication.
Unidad de Enfermedades Infecciosas, Hospital General Gregorio Marañón, Madrid, Spain. juaberber@terra.es
Juan
J
Berenguer
Fernando
F
Laguna
José
J
López-Aldeguer
Santiago
S
Moreno
José R
JR
Arribas
Julio
J
Arrizabalaga
Josu
J
Baraia
José Luis
JL
Casado
Jaime
J
Cosín
Rosa
R
Polo
Juan
J
González-García
José A
JA
Iribarren
José Ma
JM
Kindelán
Juan C
JC
López-Bernaldo de Quirós
Rogelio
R
López-Vélez
Juan F
JF
Lorenzo
Fernando
F
Lozano
Josep
J
Mallolas
José Ma
JM
Miró
Federico
F
Pulido
Esteban
E
Ribera
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001424:Bacterial Infections / Q000453:epidemiology / Q000517:prevention & control; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000517:prevention & control; D004347:Drug Interactions; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D008297:Male; D009181:Mycoses / Q000453:epidemiology / Q000517:prevention & control; D010272:Parasitic Diseases / Q000453:epidemiology / Q000517:prevention & control
D000890:Anti-Infective Agents