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Opportunistic Illness (OIs)

ICAAC 2014: New Drug Isavuconazole Is Effective Against Opportunistic Fungal Infections

A new antifungal drug, isavuconazole, matched the efficacy of voriconazole for treatment of invasive fungal infections in cancer patients with compromised immunity, but with fewer side effects, researchers reported at the 54th Interscience Conference on Antimicrobial Agents and Chemotherapy last week in Washington, DC.Isavuconazole was shown to be effective against various fungal infections that act as opportunistic illnesses in people with HIV/AIDS, including Aspergillus, Candida, and Cryptococcus.

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Updated Pediatric HIV Opportunistic Infection Guidelines Emphasize Antiretroviral Therapy

The U.S. National Institutes of Health, Centers for Disease Control and Prevention, and other medical associations have released an updated version of Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children. The latest revision emphasizes the importance of timely antiretroviral therapy as a key to preventing and managing OIs in infants and children with HIV.

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CDC Immunization Committee Recommends 2 Pneumococcal Vaccines for Immunocompromised Adults

People with compromised immune systems, including those with advanced HIV disease, should receive a combination of 2 different vaccines to prevent pneumococcal disease, the CDC's Advisory Committee on Immunization Practices (ACIP) recommended at its meeting last week in Atlanta.alt

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CDC Report: Antibiotic Drug Resistance Is a Growing Threat

Bacterial resistance to multiple antibiotics is a growing problem, affecting at least 2 million people each year in the U.S. and resulting in at least 23,000 deaths, according to a new report from the Centers for Disease Control and Prevention (CDC), which is available free online. The consequences of inaction, according to the report, are "potentially catastrophic."

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Cryptococcal Meningitis Study Halted after Early HIV Treatment Linked to Higher Mortality

A study looking at timing of antiretroviral therapy (ART) in people with cryptococcal meningitis was stopped early because patients who started HIV treatment immediately had a higher risk of death than those who waited until a few weeks after starting meningitis treatment.

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Increased Risk of AIDS-defining Illnesses Seen Even at CD4 Counts of 500-750

HIV positive people with CD4 T-cell counts in the 500-749 cells/mm3 range still have a higher risk of AIDS-defining illnesses -- especially cancers -- compared to those with more than 1000 cells/mm3, although the risk is quite low, according to a study published in the August 6, 2013, advance edition of Clinical Infectious Diseases. These findings offer further evidence of the benefits of prompt antiretroviral treatment.

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Cryptococcus May Be Misdiagnosed in People with AIDS

People with AIDS who contract cryptococcal infection may have a different organism than usually suspected, Cryptococcus gattii rather than Cryptococcus neoformans, according to a study in the September 1, 2011, online edition of PLoS Pathogens. Prevalence of C. gattii varies by region, and correct identification can help select the most effective treatment.alt

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FDA Limits Use of Oral Antifungal Ketoconazole Due to Side Effects and Drug Interactions

The antifungal drug ketoconazole (brand name Nizoral), used to treat certain AIDS-related opportunistic infections, should no longer be used as first-line oral therapy for any infection due to its potential to cause liver toxicity and adrenal gland problems, and instead should be reserved for those who cannot take or do not respond to other treatments, according to the U.S. Food and Drug Administration. The warning does not apply to topical formulations.

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Fluconazole (Diflucan) for Fungal Infections Can Cause Birth Defects, FDA Warns

Fluconazole (brand name Diflucan and generic versions) may increase the risk of birth defects when taken by pregnant women at higher doses and for prolonged periods to manage yeast infections (candidiasis) or other fungal infections. People with suppressed immune function -- including those with HIV/AIDS -- may experience recurrent or persistent yeast infections and are sometimes treated with long-term fluconazole.

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Updated Opportunistic Infection Guidelines Add Info on IRIS, Hepatitis, Drug Interactions

On May 7 the National Institutes of Health, Centers for Disease Control and Prevention, and HIV Medicine Association of the Infectious Diseases Society of Americaannounced the release of revised Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents, updating the previous version from 2009.

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Updated Recommendations for Prevention of Invasive Pneumococcal Disease

This new report from the U.S. Centers for Disease Control and Prevention (CDC) provides updated recommendations for prevention of invasive pneumococcal disease (IPD), which affects a broad spectrum of the U.S. population. The risk for IPD is highest among individuals who are immunocompromised, such as those with HIV infection or asplenia (e.g., sickle cell disease or congenital or surgical asplenia). Recommendations for revaccination among persons with immunocompromising conditions remain unchanged since the report issued in 1997. The indications for which vaccination is recommended now include smoking and asthma.

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CDC Recommends Pneumococcal Vaccine Combo for Immune Compromised People

Immunocompromised individuals, including people with HIV, should receive both the 13-valent pneumococcal conjugate vaccine Prevnar 13 and the 23-valent pneumococcal polysaccharide vaccine Pneumovax 23 to prevent pneumococcal pneumonia and invasive disease, according to the latest recommendations from the Centers for Disease Control and Prevention (CDC). alt

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People with CD4 Counts below 200 May Stop Pneumocystis Pneumonia Prophylaxis if Viral Load Is Undetectable

HIV positive people with a CD4 T-cell count between 100 and 200 cells/mm3 may be able to safely discontinue preventive medications for Pneumocystis jiroveci (formerly P. carinii) pneumonia, or PCP, if they maintain undetectable HIV RNA on combination antiretroviral therapy (ART), according to a report in the September 15, 2010 issue of Clinical Infectious Diseases.

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ICAAC 2012: Are Statins Beneficial for Patients with Candida Fungal Infections?

Use of statin drugs to manage elevated cholesterol in people at risk for cardiovascular disease may also reduce short-term mortality among people with Candida fungal infections, perhaps due to their immunomodulatory properties,according to a study presented at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012) this week in San Francisco.alt

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