Date: July 1, 2021

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

The Panel updated two sections of the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Highlights from each updated section are summarized below:

Cytomegalovirus:

  • Highlighted the toxicities of alternative antiviral medications used to treat CMV.

Cryptococcosis:

  • Recommended an increase in the dose of fluconazole from 400 mg to 800 mg daily for consolidation therapy.
  • Included results of a trial in a resource-limited setting that used only one week of amphotericin B induction therapy but did NOT recommend this approach for high-resource settings.
  • Clarified that the treatment of non-CNS extrapulmonary cryptococcosis and diffuse pulmonary disease should be the same as that for meningitis and that treatment of mild-moderate focal pulmonary infection should be with fluconazole, 400-800 mg daily.
  • Clarified treatment for patients who have been found to have asymptomatic antigenemia.
  • Revised the Pregnancy text for consistency with other sections of the guidelines.

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

Clinical Info Welcomes Your Feedback on the latest revisions to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV is welcome. Please send your comments with the subject line “Adult and Adolescent Opportunistic Infection Guidelines” to ContactUs@HIVinfo.NIH.gov by July 16, 2021.