Chart of opportunistic infections

October 2001     View PDF     En español

This publication is intended as a general guide to managing opportunistic infections (OIs). It can’t substitute for a detailed discussion of each infection. Anyone dealing with one or more of these infections should consult with their doctor.

Preventing and treating OIs is not an exact science. It often requires some complex trial-and-error to figure out the best regimen for a person. If standard drugs fail, it may be necessary to try different experimental drugs.

There’s often a gap between the drugs prescribed by doctors with large HIV practices and those prescribed by doctors with less experience. At times, people may need to bring experimental drugs to the attention of their providers who haven’t prescribed them before or do not know of their expanded access programs.

It can be challenging for some people to get the medications mentioned in this publication. Some are approved specifically for HIV disease; others are not approved for HIV but still may be prescribed for it. Most are available through clinical studies, expanded access or compassionate use programs.

However, not everyone has close or easy access to these programs or studies. Also, how individuals get prescription drugs may vary widely according to whether their healthcare is provided by private insurance or by government programs. Working closely with your doctor or finding an experienced treatment advocate may help some people access these drugs.

As more drugs become available for managing OIs, an ongoing concern is the possibility of more drug interactions. Many drugs are broken down in the liver by an enzyme called P450 cytochrome. Drugs that use this enzyme can greatly alter the blood levels of other drugs.

Drugs metabolized in the liver include clarithromycin, rifabutin, itraconazole, nevirapine, efavirenz, delavirdine, saquinavir, ritonavir, indinavir and nelfinavir. It is very important for people who take these drugs, especially those with chronic liver disease, to monitor drug side effects and efficacy. It’s also important, if possible, to obtain specific drug levels in blood so that doses can be adjusted if necessary.

For a complete list of interactions with anit-HIV drugs, read Drug Interactions.