Discontinuation of prophylaxis for HIV-associated opportunistic infections in the era of highly active antiretroviral therapy

Purpose. The rationale for recent changes in guidelines for the prevention of opportunistic infections (OIs) in HIV-infected persons is discussed. Summary. The epidemiology of AIDS has changed significantly since the advent of highly active antiretroviral therapy (HAART). Furthermore, the impact of HIV-associated OIs has decreased, leading to changes in the guidelines and recommendations for primary and secondary prophylaxis for such infections. While many patients can now be considered for discontinuation of suppressive therapy, clinical decision-making surrounding the discontinuation of primary or secondary prophylaxis must take into account each patient's individual circumstances. Continued surveillance and careful monitoring of patients who stop prophylaxis will be critical to the overall success of OI treatment and prevention programs. Conclusion. The decision to discontinue primary or secondary prophylaxis for HIV-associated OIs should be made on a case-by-case basis.