Opportunistic infections in immunocompromised

Identify medications for and efficacy of Pre-exposure prophylaxis

• Tenofovir DF/Emtricitabine

• Tenofovir AF/Emtricitabine

• Cabotegravir for IM injection

Monitoring: HIV testing, Scr, STD testing

Recognize preferred anti-retroviral therapy choice for post-exposure prophylaxis

Timing: Medication must be started within 72 hours

• Tenofovir DF/Emtricitabine OR Tenofovir AF/Emtricitabine

PLUS

• Raltegravir or Dolutegravir or

• Bictegravir 

oPEP vs nPEP

oPEP: Occupational 

nPEP: Non-occupational

Identify common opportunistic infections for immuno-compromised patients

Cytomegalovirus (CMV)
Toxoplasmosis
Mycobacterium Avium (MAC)
Pneumocystis jerovici (PJP)
Cryptococcus
Tuberculosis
Oral Candidiasis
Kaposi’s Sarcoma
Herpes

Determine CD4 count at which patients require opportunistic infection prophylaxis for: PJP, Toxoplasmosis, MAC, CMV, Cryptococcus

List preferred drugs for primary and secondary prophyalxis of each

When can you stop prophyalxis for each?

Do we need candidiasis (thrush) prophylaxis?

No- rarely life threatening