Prophylaxis of opportunistic infections

Opportunistic infections (OIs) are the hallmark of the immunodeficiency ass ociated with HIV infections. In the mid-1990s, widespread use of prophylaxi s strategies improved the morbidity and mortality of AIDS, and the guidelin es for the prevention of most infections have been promulgated. More recent ly, with the introduction of potent antiretroviral therapy, there has been a dramatic change in clinical outcome of many OIs such that antiretroviral therapy should be regarded as standard treatment for any OI. In addition, t he immune reconstitution that follows successful inhibition of HIV replicat ion raises the question of withdrawal of specific antimicrobial prophylaxis . In fact, diseases that previously required lifelong maintenance therapy m ay be potentially curable with effective antiretroviral therapy. In this ar ticle, the authors update clinicians on the current state of the art of pro phylaxis of OIs in the era of potent treatment for HIV.