title: [Treatment and prevention of opportunistic infections].
abstract: Incidence as well as morbidity and mortality of opportunistic infections (OI) have declined remarkably since the availability of antiretroviral treatment (ART). Nearly half of all persons infected with HIV however do not know their HIV-status, and the diagnosis of an OI may be the first manifestation of their HIV infection. Therefore, knowledge of the presentation of OIs as well as their management should remain an essential part of clinicians' expertise. After starting ART the immune system will improve; in this context OI may be unmasked or the clinical presentation of known OI may worsen. Before starting ART therefore, it is essential to rule out any asymptomatic or latent OI. For the same reason, in the case of a known OI, the start of ART must often be deferred for some weeks after the start of OI treatment. Treatment of OIs is complex and often results in a large pill-burden for the patient with the potential for multiple drug-drug-interactions, particularly once ART has to be started. Many of the OI treatments are also associated with frequent drug side-effects and allergies. OIs can be prevented with specific antimicrobial agents once the CD4 have decreased below a defined threshold. However, the main prevention of OI is the timely recognition of HIV infection and an early start of ART before complications of OI appear.
authors.affiliation: Universitätsklinik für Infektiologie, Inselspital Bern.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Staehelin
authors.affiliation: Klinik für Infektiologie und Spitalhygiene, Universitätsspital Basel.
authors.forename: Luigia
authors.initials: L
authors.lastname: Elzi
authors.affiliation: Klinik für Infektionskrankheiten und Spitalhygiene, Universitätsspital Zürich.
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.affiliation: Universitätsklinik für Infektiologie, Inselspital Bern.
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000517:prevention & control; D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy* / Q000517:prevention & control; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D004359:Drug Therapy, Combination; D006801:Humans; D011379:Prognosis; D055502:Secondary Prevention; D019562:Viral Load / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents