Table of Contents 1 Introduction 1.1 Antiretroviral therapy 1.2 The patient pathway 1.3 References 2 Central nervous system opportunistic infections 2.1 Methods 2.2 Introduction 2.3 General overview 2.4 Cryptococcus neoformans 2.4.1 Background and epidemiology 2.4.2 Presentation 2.4.3 Diagnosis 2.4.4 Treatment 2.4.5 Prophylaxis 2.4.6 Impact of HAART 2.5 Toxoplasma gondii 2.5.1 Background and epidemiology 2.5.2 Presentation 2.5.3 Diagnosis 2.5.4 Treatment 2.5.5 Prophylaxis 2.5.6 Impact of HAART 2.6 Progressive multifocal leukoencephalopathy (PML) 2.6.1 Background and epidemiology 2.6.2 Presentation 2.6.3 Diagnosis 2.6.4 Treatment 2.6.5 Prophylaxis 2.6.6 Impact of HAART 2.7 Cytomegalovirus (CMV) 2.7.1 Background and epidemiology 2.7.2 Presentation 2.7.3 Diagnosis 2.7.4 Treatment 2.7.5 Prophylaxis 2.7.6 Impact of HAART 2.8 References 3 Pulmonary opportunistic infections 3.1 Methods 3.2 Introduction 3.3 General overview 3.4 Pneumocystis jirovecii 3.4.1 Background and epidemiology 3.4.2 Presentation 3.4.3 Diagnosis 3.4.4 Treatment 3.4.5 Prophylaxis 3.4.6 Impact of HAART 3.5 Bacterial pneumonia 3.5.1 Background and epidemiology 3.5.2 Presentation 3.5.3 Treatment 3.5.4 Impact of HAART 3.6 Cryptococcus neoformans 3.6.1 Background and epidemiology (see section 2.4 Cryptococcus neoformans) 3.6.2 Presentation 3.6.3 Diagnosis 3.6.4 Treatment 3.6.5 Prophylaxis 3.6.6 Impact of HAART 3.7 Aspergillosis 3.7.1 Background and epidemiology 3.7.2 Presentation 3.7.3 Diagnosis 3.7.4 Treatment 3.7.5 Prophylaxis 3.7.6 Impact of HAART 3.8 Cytomegalovirus (CMV) 3.8.1 Background and epidemiology 3.8.2 Presentation 3.8.3 Diagnosis 3.8.4 Treatment 3.8.5 Prophylaxis 3.8.6 Impact of HAART 3.9 Influenza A virus (IAV) 3.9.1 Background and clinical presentation 3.9.2 Diagnosis 3.9.3 Treatment 3.9.4 Prevention 3.10 References 4 Gastrointestinal opportunistic infections 4.1 Methods 4.2 General overview 4.3 Oesophagitis 4.4 Diarrhoea 4.4.1 Acute diarrhoea due to bacteria and viruses 4.4.2 Cytomegalovirus 4.4.3 Cryptosporidium spp 4.4.4 Microsporidiosis 4.4.5Other parasites and helminths causing diarrhoea (usually chronic) 4.5 References 5 Ocular infections 5.1 CMV retinitis (CMVR) 5.1.1 Background and epidemiology 5.1.2 Presentation 5.1.3 Diagnosis 5.1.4 Treatment 5.1.5 Maintenance and duration of anti-CMV treatment for CMVR 5.1.6 Reactivation or progression of CMVR 5.1.7 Resistance to anti-CMV treatment 5.1.8 Pregnancy and breastfeeding 5.1.9 Impact of HAART 5.2 Other ocular infections of particular importance in the setting of HIV 5.2.1 Syphilis 5.2.2 Toxoplasmosis 5.2.3 Varicella zoster virus retinitis 5.3 References 6 Herpes viruses 6.1 Introduction 6.2 Varicella zoster virus 6.2.1 Methods 6.2.2 Background 6.2.3 Epidemiology 6.2.4 Presentation 6.2.5 Diagnosis 6.2.6 Treatment 6.2.7 Prophylaxis against varicella 6.3 Herpes simplex virus (HSV) infection 6.3.1 Methods 6.3.2 Background and epidemiology 6.3.3 Presentation 6.3.4 Diagnosis 6.3.5 Treatment 6.3.6 Antiretroviral therapy 6.4 References 7 Candidiasis 7.1 Methods 7.2 Background and epidemiology 7.3 Presentation 7.4 Diagnosis 7.5 Treatment 7.6 Prophylaxis 7.7 Impact of HAART 7.8 References 8 Mycobacterium avium complex and Mycobacterium kansasii 8.1 Methods 8.2 Introduction 8.3 Mycobacterium avium complex 8.3.1 Background and epidemiology 8.3.2 Presentation 8.3.3 Diagnosis 8.3.4 Treatment 8.3.5 Primary prophylaxis 8.3.6 Impact of HAART 8.4 Mycobacterium kansasii 8.4.1 Background and epidemiology 8.4.2 Presentation 8.4.3 Diagnosis 8.4.4 Treatment 8.4.5 Prophylaxis 8.4.6 Impact of HAART 8.5 References 9 Pyrexia of unknown origin (PUO) 9.1 Background 9.2 Clinical evaluation 9.2.1 A detailed history should include: 9.2.2 Examination of the patient should include: 9.2.3 Initial investigations 9.3The choice and utility of invasive diagnostic tests 9.3.1 Bone marrow examination (BME) 9.3.2 Fine needle aspirate biopsy (FNAB) of lymph nodes 9.3.3 Lymph node sampling 9.3.4 Percutaneous liver biopsy (PLB) 9.3.5 Imaging 9.4 References 10 Travel-related opportunistic infections 10.1 Methods 10.2 Introduction 10.3 Malaria 10.3.1 Background and epidemiology 10.3.2 Presentation 10.3.3 Diagnosis 10.3.4 Treatment 10.3.5 Prophylaxis 10.4 Leishmaniasis 10.4.1 Background and epidemiology 10.4.2 Presentation 10.4.3 Diagnosis 10.4.4 Treatment 10.4.5 Prophylaxis 10.4.6 Impact of HAART 10.5 Chagas disease (Trypanosoma cruzi) 10.5.1 Background and epidemiology 10.5.2 Presentation 10.5.3 Diagnosis 10.5.4 Treatment 10.5.5 Prophylaxis 10.5.6 Impact of HAART 10.6 Histoplasmosis, blastomycosis and coccidioidomycosis 10.6.1 Background and epidemiology 10.6.2 Presentation 10.6.3 Diagnosis 10.6.4 Treatment 10.6.5 Prophylaxis 10.6.6 Impact of HAART 10.7 Penicilliosis 10.7.1 Background and epidemiology 10.7.2 Presentation 10.7.3 Diagnosis 10.7.4 Treatment 10.7.5 Prophylaxis 10.7.6 Impact of HAART 10.8 References 11 Special considerations in pregnancy 11.1 Background and epidemiology 11.2 Diagnostic considerations in HIV-seropositive pregnant women 11.2.1 Radiology 11.3 Diagnostic considerations for the foetus and newborn baby 11.3.1 Foetal monitoring 11.3.2 Vertical transmission of maternal opportunistic infections to the neonate 11.4 Treatment considerations for specific opportunistic infections 11.4.1 Pneumocystis jirovecii (PCP) 11.4.2 Cryptococcus neoformans 11.4.3 Candida infections 11.4.4 Toxoplasma gondii 11.4.5 Cytomegalovirus (CMV) 11.4.6 Herpes simplex virus (HSV) and varicella zoster virus (VZV) 11.4.7 Mycobacterium tuberculosis 11.4.8 Mycobacterium avium complex 11.5 Impact of HAART 11.6 Potential antiretroviral drug interactions 11.7 References 12 Intensive care 12.1 Background 12.2 Antiretroviral therapy on the ICU 12.3 References 13 A-Z of drugs used in the treatment of opportunistic infections in HIV (Appendix 1) Appendix 2
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Nelson et al. (2011) studied this question.