July 23, 1997

Preventing Opportunistic Infections in Persons Infected With HIV: 1997 Guidelines

Author Affiliations

From the National Center for Infectious Diseases (Drs Kaplan and Jaffe) and the National Center for HIV, STD, and TB Prevention (Dr Kaplan), Centers for Disease Control and Prevention, Atlanta, Ga; the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md (Dr Masur); and the Center for AIDS and STD, University of Washington, Seattle (Dr Holmes).

JAMA. 1997;278(4):337-338. doi:10.1001/jama.1997.03550040093045

AN ESTIMATED 650 000 to 900 000 residents of the United States are currently infected with human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS).1 Opportunistic infections (OIs) exact a great toll in terms of morbidity and mortality among the estimated 200 000 to 250 000 persons with severe immunosuppression, as defined by a CD4* T-lymphocyte count of less than 0.20x109/L.2,3 Data collected from 1990 to 1994 suggest that the 1- and 2-year incidence rates of any AIDS-defining illness in this population were 33% and 58%.4 The direct costs of the HIV epidemic in the United States, most of which have resulted from hospitalizations for these illnesses, were projected to reach $15 billion for the year 1995.5 Although the incidence of OIs appears to be decreasing because of antiretroviral therapy and chemoprophylaxis against specific OIs—at least in some HIV-infected populations6—prevention