Prophylactic Pharmacotherapy for HIV-Related Opportunistic Infections

Preventive Strategies for Mycobacterium Avium Complex (MAC) Infection

Mycobacterium Avium Complex (MAC) infection is a significant opportunistic infection in individuals with advanced HIV/AIDS, characterized by systemic symptoms and high morbidity.

Understanding MAC Infection

MAC infection is caused by Mycobacterium avium and Mycobacterium intracellulare, leading to disseminated disease in immunocompromised patients.

Risk Factors

• CD4 count < 50 cells/mm³
• Severe immunosuppression
• Previous opportunistic infections

Prophylactic Pharmacotherapy

Primary prevention of MAC infection involves pharmacological strategies aimed at reducing bacterial colonization and dissemination.

Recommended Agents

• Azithromycin: 1200 mg weekly
• Clarithromycin: 500 mg twice daily
• Rifabutin: 300 mg daily (alternative regimen)

Clinical Considerations

Prophylaxis is generally discontinued when patients achieve immune reconstitution with ART and maintain a CD4 count ≥ 100 cells/mm³ for at least three months.

Conclusion

Prophylactic therapy significantly reduces MAC-related morbidity among HIV patients with profound immunosuppression. Timely ART initiation remains the cornerstone of prevention.