Preventing Opportunistic Infections in Persons Infected With HIV: 1997 Guidelines

AN ESTIMATED 650 000 to 900 000 residents of the United States are currently infected with human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS).1Opportunistic infections (OIs) exact a great toll in terms of morbidity and mortality among the estimated 200 000 to 250 000 persons with severe immunosuppression, as defined by a CD4*T-lymphocyte count of less than 0.20x109/L.2,3Data collected from 1990 to 1994 suggest that the 1- and 2-year incidence rates of any AIDS-defining illness in this population were 33% and 58%.4The direct costs of the HIV epidemic in the United States, most of which have resulted from hospitalizations for these illnesses, were projected to reach $15 billion for the year 1995.5Although the incidence of OIs appears to be decreasing because of antiretroviral therapy and chemoprophylaxis against specific OIs—at least in some HIV-infected populations6—prevention