The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV have been updated. 

Mycobacterium avium Complex 

• Updated information to prioritize the initiation of effective antiretroviral therapy (ART) and to refrain from primary prophylaxis for Mycobacterium avium Complex (MAC) except for people with HIV who are not receiving ART, remain viremic on ART, or have no options for a fully suppressive ART regimen.  
• Added new information indicating that drugs demonstrating substantive in vitro activity against MAC might be considered for the treatment of refractory MAC disease (e.g., bedaquiline, tedizolid, linezolid, omadacycline), acknowledging that there is insufficient observational or clinical trial data to support formal recommendations in this setting.
• Updated information on drug–drug interactions between anti-MAC therapies, particularly rifabutin, and antiretroviral drugs and provided a link to the Adult and Adolescent Antiretroviral Guidelines on drug–drug interactions. 

These guidelines are published in an electronic format and updated as changes in prevention and treatment science occurs. All updates are developed by the subject matter groups listed in Appendix B. Guideline updates are reviewed by scientific content experts. 

For a list of recent updates, please see What's New in the Guidelines. To view or download the guidelines, go to the Adult and Adolescent Opportunistic Infections Guidelines section of the Clinicalinfo website. The guidelines tables and recommendations also can be downloaded as separate PDF files.  

Clinicalinfo welcomes your feedback on the latest revisions to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Please send your comments with the subject line “Adult and Adolescent Opportunistic Infection Guidelines” to HIVinfo@NIH.gov by September 5, 2024.