Prophylaxis against Opportunistic Infections in Patients with Human Immunodeficiency Virus Infection

Soon after the acquired immunodeficiency syndrome (AIDS) was first described in 1981,14 it became clear that opportunistic infections occurred with remarkable frequency and caused substantial morbidity and mortality among patients with AIDS. On the basis of a series of clinical trials, chemoprophylaxis to prevent initial episodes of certain opportunistic infections (primary prophylaxis) and subsequent episodes (secondary prophylaxis) became the standard of care. The success of highly active antiretroviral therapy (defined as combination antiretroviral regimens that include either a potent viral-protease inhibitor or a nonnucleoside reverse-transcriptase inhibitor) in reducing the incidence of AIDS-related opportunistic infections and consequent morbidity and mortality . . .