Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV

The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV document is published in an electronic format and updated as relevant changes in prevention and treatment recommendations occur.

All changes are developed by the subject-matter groups listed in the document. (Changes in group composition also are posted promptly.) These changes are reviewed by the editors and by relevant outside reviewers before the document is altered. Major revisions within the last six months are as follows:

September 28, 2022

Monkeypox

• Added links to useful government and professional association websites.
   

September 7, 2022

Hepatitis B Virus

• Updated the information on vaccines to recommend a double-dose recombinant hepatitis B vaccine and to include as an alternative the recombinant HBsAg vaccine conjugated to CpG 1018 (Heplisav-B).
• Emphasized avoidance of dolutegravir/lamivudine (3TC) for antiretroviral therapy for people who are HBsAg positive because 3TC is the only active drug against hepatitis B virus in this regimen.

Immunization

• Harmonized recommendations for the hepatitis B vaccine with the updated Hepatitis B Virus section (see above).
• Noted that two new pneumococcal conjugate vaccines are now preferred for protection against invasive pneumococcal disease: PCV15 (given in series with PPSV23) and PCV20 (given as a single vaccine).
• Recommended the recombinant herpes zoster vaccine (RZV) for all individuals with HIV who are 18 years and older rather than 50 years and older.
   

August 1, 2022

Monkeypox

• Added a brief statement about monkeypox with a link to information from the Centers for Disease Control and Prevention (CDC).
• Information about monkeypox as an HIV-related opportunistic infection will be added to this guideline as relevant data emerge.
   

April 12, 2022

Bacterial Enteric Infections

• Updated information on the management and treatment of Clostridioides difficile (C. difficile) disease now aligned with the recent Infectious Diseases Society of America guidelines.
• Expanded discussion of the role of fidaxomicin and bezlotoxumab in the therapy of C. difficile disease.