21.6  Prevention of opportunistic infections

It is very important to know about measures to reduce the risk of developing opportunistic infections in PLHIV, some of which can be fatal. Prevention is carried out by giving certain drugs to PLHIV on a daily basis, before they develop symptoms of the disease, in this case, opportunistic infections. As you learnt in Study Session 1, the use of drugs for the prevention of common infectious diseases is called chemoprophylaxis. Good prophylaxis is not expensive or complicated, but can increase the duration and quality of life of a person living with HIV.

  • Give one example of a chemoprophylactic drug used in prevention of an infectious disease, which you learned about in Part 2 of this Module.

  • Isoniazid is a chemoprophylatic drug used to prevent TB infection in children and PLHIV (Study Session 16).

The most commonly used prophylactic drug for HIV/AIDS is cotrimoxazole, a wide-spectrum antibiotic that targets the pathogens causing the most common opportunistic infections. These include pneumonia, brain abscess and chronic diarrhoea caused by protozoans, as well as by some bacterial infections. Note that you do not need to memorise these infections as they need to be diagnosed at a health centre or regional hospital. However, you will need to closely monitor patients on cotrimoxazole in your community on follow-up visits or consultations, in order to check whether they are taking their drugs correctly, and/or to refer them if they experience adverse side-effects.

21.5  Opportunistic infections and provider-initiated counselling and testing

21.6.1  Criteria for starting cotrimoxazole prophylaxis by adult PLHIV