Prophylaxis of opportunistic infections in HIV-infected patients in the HAART era

Quality of life and duration of survival in patients with HIV infection have improved with better understanding of opportunistic infections and their prophylaxis and with implementation of HAART. Current questions include whether continued prophylaxis is needed in patients who respond favorably to HAART; whether prophylaxis can be discontinued when CD4 cell counts rise above a critical level even when clinical improvement while receiving HAART is suboptimal; and how to initiate treatment in patients unaware of their HIV infection who present initially with opportunistic infections.