Key Decisions in HIV Care: Managing ART With Opportunistic Infections

In this episode from the series “Key Decisions in HIV Care,” Cristina Mussini, MD, and William R. Short, MD, MPH, AAHIVS, discuss important considerations for ART with opportunistic infections, including:

• When to start ART with pneumocystis pneumonia including discussion of the ACTG 5164 study of immediate vs delayed ART with opportunistic infections
• EACS, DHHS, and IAS-USA guideline recommendations for starting ART in the setting of most opportunistic infections
• Considerations for the administration of ART to patients who are unable to swallow or critically ill and intubated
• Treatment of Kaposi sarcoma and considerations for starting ART to avoid drug–drug interactions with Kaposi sarcoma treatment
• Considerations for starting ART with cytomegalovirus and the risk for IRIS from cytomegalovirus
• Discussion of treatment of cytomegalovirus and overlapping toxicities between its treatment and ART
• When to start ART with cryptococcal meningitis and the data to support delayed treatment initiation with this particular opportunistic infection
• EACS, DHHS, and IAS-USA guideline recommendations for starting ART in the setting of cryptococcal meningitis specifically
• Treatment of cryptococcal meningitis and managing drug–drug interactions between ART and antifungal therapy