Home Prophylaxis Prophylaxis for the immunocompromised host
Home Prophylaxis Prophylaxis for the immunocompromised host

HIV-infectie

Advices

≥ 18 years

Indications: Pneumocystis jiroveci - primaire profylaxe indien CD4 cellen < 200/mm3, profylaxe stoppen indien CD4 cellen > 200/mm3 gedurende 3-6 maanden; profylaxe herstarten indien CD4 cellen < 200/mm3
Priority Medication Remarks
Priority:
 1st choice 		Medication:

cotrimoxazol (trimethoprim +sulfamethoxazol) po 480mg 1dd
≥ 18 years

Indications: Pneumocystis jiroveci - secundaire profylaxe
Priority Medication Remarks
Priority:
 1st choice 		Medication:

cotrimoxazol (trimethoprim +sulfamethoxazol) po 480mg 1dd
≥ 18 years

Indications: Pneumocystis jiroveci - primaire/secundaire profylaxe
Priority Medication Remarks
Priority:
 2nd choice 		Medication:

pentamidine inhalation 300mg 1 per 4 weeks
Priority:
 3rd choice 		Medication:

dapsone po 100mg 1dd
Priority:
 4th choice 		Medication:

atovaquon po 1500mg 1dd
≥ 18 years

Indications: Toxoplasma gondii - secundaire profylaxe, Stoppen indien CD4 cellen > 200/mm3 gedurende 3-6 maanden; profylaxe herstarten indien CD4 cellen < 100/mm3.
Priority Medication Remarks
Priority:
 1st choice 		Medication:

pyrimethamine po 50mg 1dd

+

sulfadiazine po 1000mg 2dd

+

folinezuur po 15mg 1dd
Priority:
 2nd choice 		Medication:

clindamycine po 300mg 4dd

+

pyrimethamine po 50mg 1dd

+

folinezuur po 15mg 1dd
Remarks:

PJP profylaxe toevoegen
Priority:
 3rd choice 		Medication:

atovaquon po 750mg 2dd

+

pyrimethamine po 25mg 1dd

+

folinezuur po 10mg 1dd
Priority:
 4th choice 		Medication:

dapsone po 50mg 1dd

+

pyrimethamine po 50mg 1pw

+

folinezuur po 25mg 1pw
≥ 18 years

Indications: Cryptococcus neoformans - secundaire profylaxe, stoppen indien CD4 cellen > 200/mm3 gedurende 3-6 maanden; profylaxe herstarten indien CD4 cellen < 200/mm3
Priority Medication Remarks
Priority:
 1st choice 		Medication:

fluconazol po 200mg 1dd
Priority:
 2nd choice 		Medication:

amfotericine B conventioneel (Fungizone) iv 1mg/kg 1pw
≥ 18 years

Indications: Candida - secundaire profylaxe, bij frequente, ernstige recidieven
Priority Medication Remarks
Priority:
 1st choice 		Medication:

fluconazol po 50mg 1dd
Remarks:

Intermitterend bij klachten
Priority:
 2nd choice 		Medication:

itraconazol po 200mg 1dd
≥ 18 years

Indications: CMV retinitis - secundaire profylaxe, stoppen indien CD4 cellen>100/mm3 gedurende 3-6 maanden en inactieve ziekte [i.o.m. oogarts]
Priority Medication Remarks
Priority:
 1st choice 		Medication:

valganciclovir po 900mg 1dd
Remarks:

Bij voorkeur gecombineerd met intraoculair ganciclovir implantaat
≥ 18 years

Indications: CMV neurologische ziekte - secundaire profylaxe
Priority Medication Remarks
Priority:
 1st choice 		Medication:

valganciclovir po 900mg 2dd
Priority:
 2nd choice 		Medication:

ganciclovir iv 5mg/kg 1dd
≥ 18 years

Indications: HSV - secundaire profylaxe, is alleen geïndiceerd bij frequente of ernstige recidiverende herpes infecties [> 5-6 ernstige episodes per jaar]
Priority Medication Remarks
Priority:
 1st choice 		Medication:

valaciclovir po 500mg 2dd
Priority:
 1st choice alternative 		Medication:

famciclovir po 500mg 2dd
≥ 18 years

Indications: Tuberculose
Priority Medication Remarks
Priority:
 1st choice 		Medication:

isoniazide po 300mg 1dd 9 months

General comments

CMV oesophagitis of colitis: secundaire profylaxe meestal niet nodig, overwegen bij een relaps (waarvoor eerst herbehandeling).

Sources

Antimicrobial resources

The following antimicrobial agents have been used in these recommendations:

External antimicrobial resources
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Metadata

Swab vid: G-147498.6
Updated: 05/17/2022 - 12:55
Status: Published