Prophylaxis for HIV-Related Infections: A Work in Progress
Authors: William G. Powderly
Journal: Annals of Internal Medicine (1996)

Editorials1 February 1996Prophylaxis for HIV-Related Infections: A Work in ProgressWilliam G. Powderly, MD, FRCPIWilliam G. Powderly, MD, FRCPIWashington University School of Medicine St. Louis, MO 63108Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-3-199602010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Although promising recent advances have been made in antiretroviral therapy, human immunodeficiency virus (HIV) infection remains a lethal problem for infected patients. Opportunistic infections are clearly the most important complication of HIV infection, and they cause considerable morbidity and mortality. Prophylaxis for Pneumocystis carinii pneumonia has been standard care in HIV therapeutics for almost a decade, and the result of this has been increased survival and delay in the onset of other illnesses related to the acquired immunodeficiency syndrome (AIDS) [1]. In the last year, the results of clinical trials showing effective prophylaxis for the most common HIV-related opportunistic infections—systemic ...References1. Hoover DR, Saah AJ, Bacellar H, Phair J, Detels R, Anderson R, et al. Clinical manifestations of AIDS in the era of pneumocystis prophylaxis. Multicenter AIDS Cohort Study. N Engl J Med. 1993; 329:1922-6. Google Scholar2. “USPHS/IDSA guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus: a summary. Ann Intern Med. 1996; 3:348-68.” Google Scholar3. Carr A, Penny R, Cooper DA. Efficacy and safety of rechallenge with low-dose trimethoprim-sulfamethoxazole in previously hypersensitive HIV-infected patients. AIDS. 1993; 7:65-71. Google Scholar4. Bozzette SA, Finkelstein DM, Spector SA, Frame P, Powderly WG, He W, et al. A randomized trial of three antipneumocystis agents in patients with advanced human immunodeficiency virus infection. NIAID AIDS Clinical Trials Group. N Engl J Med. 1995; 332:693-9. Google Scholar5. Clumeck N. Primary prophylaxis against opportunistic infections in patients with AIDS [Editorial]. N Engl J Med. 1995; 332:739-40. Google Scholar6. Saah AJ, Hoover DR, Peng Y, Phair JP, Visscher B, Kingsley A, et al. Predictors for failure of Pneumocystis carinii pneumonia prophylaxis. Multicenter AIDS Cohort Study. JAMA. 1995; 273:1197-202. Google Scholar7. Pierce M, Lamarca A, Jablonowski H, Jemsek J, Faekenheuer G, Youle M, et al. A placebo-controlled trial of clarithromycin prophylaxis against MAC infection in AIDS patients [Abstract]. In: Program and Abstracts—34th Inter-science Conference on Antimicrobial Agents and Chemotherapy, Orlando, October 1994. Washington, DC: American Society for Microbiology; 1994:A/2. Google Scholar8. Nightingale SD, Cameron DW, Gordin FM, Sullam PM, Cohn DL, Chaisson RE, et al. Two controlled trials of rifabutin prophylaxis against Mycobacterium avium complex infection in AIDS. N Engl J Med. 1993; 329:828-33. Google Scholar9. Powderly WG, Finkelstein D, Feinberg J, Frame P, He W, van der Horst C, et al. A randomized trial comparing fluconazole with clotrimazole troches for the prevention of fungal infections in patients with advanced human immunodeficiency virus infection. NIAID AIDS Clinical Trials Group. N Engl J Med. 1995; 332:700-5. Google Scholar10. Spector SA, McKinley G, Drew WL, Stempien MJ for the Syntex Ganciclovir Study Group. A randomized double-blind study of the efficacy and safety of oral ganciclovir for the prevention of cytomegalovirus disease in HIV-infected patients [Abstract]. In: Program and Abstracts—34th Interscience Conference on Antimicrobial Agents and Chemotherapy, Orlando, October 1994. Washington, DC: American Society for Microbiology; 1994:A/9. Google Scholar11. Brosgart CL, Craig C, Hillman D, Louis TA, Alston B. A randomized, placebo-controlled trial of the safety and efficacy of oral ganciclovir for prophylaxis of CMV retinal and gastrointestinal mucosal disease in HIV-infected individuals with severe immunosuppression [Abstract]. In: Program and Abstracts—35th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, September 1995. Washington, DC: American Society for Microbiology; 1995. Google Scholar12. Johnson EM, Warnock DW, Luker J, Porter SR, Scully C. Emergence of azole drug resistance in candida species from HIV-infected patients receiving prolonged fluconazole therapy for oral candidosis. J Antimicrob Chemother. 1995; 35:103-14. Google Scholar13. Havlir D, Torriani F, Dube M. Uveitis associated with rifabutin prophylaxis. Ann Intern Med. 1995; 121:510-2. Google Scholar14. Hansen KK, Ricksten A, Hofmann B, Norrild B, Olofsson S, Mathiesen L. Detection of cytomegalovirus DNA in serum correlates with clinical cytomegalovirus retinitis in AIDS. J Infect Dis. 1994; 170:1271-4. Google Scholar15. Rasmussen L, Morris S, Zipeto D, Fessel J, Wolitz R, Dowling A, et al. Quantitation of human cytomegalovirus DNA from peripheral blood cells of human immunodeficiency virus-infected patients could predict cytomegalovirus retinitis. J Infect Dis. 1995; 171:177-82. Google Scholar Author, Article, and Disclosure InformationAuthors: William G. Powderly, MD, FRCPIAffiliations: Washington University School of Medicine St. Louis, MO 63108Grant Support: In part by grant AI-25903 from the National Institutes of Health.Corresponding Author: William Powderly, MD, AIDS Clinical Trials Unit, Washington University School of Medicine, 4511 Forest Park, St. Louis, MO 63108 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUSPHS/IDSA Guidelines Metrics Cited byMultiplex PCR assay for simultaneous detection and differentiation of Mycobacterium tuberculosis , Mycobacterium avium complexes and other Mycobacterial species directly from clinical specimensAnalysis of life-long strategies to prevent Pneumocystis carinii pneumonia in patients with variable HIV progression rates 1 February 1996Volume 124, Issue 3Page: 342-344KeywordsAIDSClinical trialsCytomegalovirus infectionDrugsHIV infectionsInfectious diseasesLymphocytesOpportunistic infectionsPneumoniaProphylaxis ePublished: 15 August 2000 Issue Published: 1 February 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...