What's New in the U.S. HHS Opportunistic Infections Guidelines for HIV-Infected Adults and Adolescents?

The Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV Infected Adults and Adolescents document was published in an electronic format that could be easily updated as relevant changes in prevention and treatment recommendations occur.

The editors and subject matter experts are committed to timely changes in this document because so many health care providers, patients, and policy experts rely on this source for vital clinical information.

All changes are developed by the subject matter groups listed in the document (changes in group composition are also promptly posted). These changes are reviewed by the editors and by relevant outside reviewers before the document is altered.

Major revisions within the last 6 months are as follows:

October 28, 2014:

1. Hepatitis C Virus: The therapy of Hepatitis C virus is changing with dramatic speed as more and more directly acting anti-HCV drugs are studied and approved. The Infectious Disease Society of America and the American Association for the Study of Liver Disease (IDSA-AASLD) with the International Antiviral Society (IAS-USA) have created an on-line guidance that is updated regularly throughout the year (www.hcvguidelines.org). The Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV Infected Adults and Adolescents and the IDSA-AASLD Guideline have overlapping members. Thus, these Opportunistic Infection Guidelines will no longer make specific treatment recommendations, but will link to that guideline so that recommendations are harmonized and current.
2. Mucocutaneous Candidiasis: New information has been included about the efficacy of posaconazole for mucocutaneous candidiasis, including references to new formulations of the drug. The term "secondary prophylaxis" as it relates to candidiasis has been replaced by "chronic suppressive therapy" to more clearly communicate the concepts that relate to recurrent candidiasis.
3. Bacterial Enteric Infections: Updated information is provided on diagnosis of C. difficile infection in diarrheal specimens. A stronger recommendation is made for treatment of Salmonellosis in all HIV-infected persons. Since Shigella spp. with reduced sensitivity to azithromycin has been reported in men who have sex with men, this drug is not recommended for treatment of Shigella spp. bacteremia.