BHIVA draft guidelines for the treatment of opportunistic infections (2010): online for comment
The 2010 British HIV Association guidelines for the treatment of opportunistic infection in HIV-positive individuals are now posted to the BHIVA website for comment.
Advances in the treatment of HIV infection with antiretroviral therapy have led to dramatic reductions in opportunistic infections and death. However, late presentation of HIV remains a problem and is a significant contributory cause to death in HIV-positive persons in the UK. Furthermore, a recent UK Health Protection Agency (HPA) analysis showed that of 46,700 patients with diagnosed HIV, 19% had CD4 counts <200 cells/mm3 and therefore remain at significant risk of opportunistic infection.
These guidelines have been drawn up to help physicians investigate and manage HIV-positive patients suspected of, or having an opportunistic infection (OI). The early chapters consider the most common presentations of OI disease such as respiratory, gastrointestinal and neurological disease. Then follow specific organisms such as Candida spp, herpes simplex virus and varicella zoster virus. Finally, special circumstances including pregnancy, the use of the intensive care unit, fever of undetermined origin and management of imported infections, are also addressed.
Each section contains information on the background, epidemiology, presentation, treatment and prophylaxis of OIs. Further information on the role of antiretroviral therapy is also discussed (see below).
The Guidelines Writing Group is grateful for all comments, which will be reviewed before publication.