Journal Article

Epidemiology of Human Immunodeficiency Virus-Associated Opportunistic Infections in the United States in the Era of Highly Active Antiretroviral Therapy

Jonathan E. Kaplan, Debra Hanson, Mark S. Dworkin, Toni Frederick, Jeanne Bertolli, Mary Lou Lindegren, Scott Holmberg and Jeffrey L. Jones

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue Supplement_1, pages S5-S14
Published in print April 2000 | ISSN: 1058-4838
Published online April 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313843
Epidemiology of Human Immunodeficiency Virus-Associated Opportunistic Infections in the United States in the Era of Highly Active Antiretroviral Therapy

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The incidence of nearly all AIDS-defining opportunistic infections (OIs) decreased significantly in the United States in the years 1992–1998; decreases in the most common OIs (Pneumocystis carinii pneumonia [PCP], esophageal candidiasis, and disseminated Mycobacterium avium complex [MAC] disease) were more pronounced in 1995–1998, during which time highly active antiretroviral therapy (HAART) was introduced into medical care. Those OIs that continue to occur do so at low CD4+ lymphocyte counts, and persons whose CD4+ lymphocyte counts have increased in response to HAART are at low risk for OIs, a circumstance suggesting a high degree of immune reconstitution associated with HAART. PCP, the most common serious OI, continues to occur primarily in persons not previously receiving medical care. The most profound effect on survival of patients with AIDS is conferred by HAART, but specific OI prevention measures (prophylaxis against PCP and MAC and vaccination against Streptococcus pneumoniae) are associated with a survival benefit, even when they coincide with the administration of HAART. Continued monitoring of incidence trends and detection of new syndromes associated with HAART are important priorities in the HAART era.

Journal Article.  6180 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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