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JAC Advance Access published online on September 29, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh438
© 2004 by The British Society for Antimicrobial Chemotherapy
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Leading article

Impact of highly active antiretroviral therapy on incidence and management of human immunodeficiency virus-related opportunistic infections

Chien-Ching Hung 1* and Shan-Chwen Chang 2

1 Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
2 Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

* To whom correspondence should be addressed. E-mail: hcc0401{at}ha.mc.ntu.edu.tw.


  Abstract

We review the changes in incidences of HIV-related opportunistic infections and the safety of discontinuation of primary and secondary prophylaxis for HIV-related opportunistic infections in patients achieving immune restoration after the introduction of highly active antiretroviral therapy (HAART). HIV-related opportunistic infections continue to occur in patients who are newly diagnosed with HIV infection, those in the early course of HAART or non-adherent to HIV care and HAART, and those in whom non-HIV-related infections have emerged as a significant cause of morbidity and mortality in the post-HAART era. Clinical studies of patients with tuberculosis and HIV co-infection are reviewed to provide appropriate regimen combinations of rifamycins and antiretrovirals, which have varying degrees of drug-drug interactions that have posed challenges in the management of tuberculosis as well as HIV infection.

Keywords: HIV infection; AIDS; HAART; opportunistic infections; antimicrobial prophylaxis.
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