Abstract
Chemotherapy for HIV-related hematological malignancies is associated with an increased risk of infection due to myelosuppression and additional CD4 lymphocyte count loss. The risk of infection may be further increased by the presence of central venous catheters or by neutropenia associated with HIV infection. Prophylaxis against PcP is strongly recommended when the CD4 cell count falls below 200 cells/μl with trimethoprim-sulfamethoxazole being the agent of choice. Prophylactic fluoroquinolones may be advocated for patients undergoing intensive chemotherapy who are likely to have prolonged (>8 days) and profound (ANC <500 cells/μl) neutropenia. Prophylaxis against MAC is recommended for individuals with a CD4 cell count less than 50 cells/μl and systemic antifungal prophylaxis may be given to patients with CD4 counts <100 cells/μl. Herpes simplex prophylaxis should be generally offered only to patients with a history of herpes simplex virus infection.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Tacconelli E, Tumbarello M, de Gaetano DK, et al. Morbidity associated with central venous catheter-use in a cohort of 212 hospitalized subjects with HIV infection. J Hosp Infect. 2000;44:186–92.
Levine AM, Karim R, Mack W, et al. Neutropenia in human immunodeficiency virus infection: data from the women’s interagency HIV study. Arch Intern Med. 2006;166:405–10.
European AIDS Clinical Society guidelines Version 7.1 Nov 2014. Part V: opportunistic infections. p. 76–81. http://www.eacsociety.org/files/guidelines-7.1-english.pdf.
Masur H, Brooks JT, Benson CA, et al. Prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: updated guidelines from the centers for disease control and prevention, National Institutes of Health, and HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58:1308–11.
Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed 06 Apr 2015.
Nelson M, Dockrell D, Edwards S, et al. British HIV Association and British Infection Association guidelines for the treatment of opportunistic infection in HIV seropositive individuals 2011. HIV Med. 2011;12 Suppl 2:1–140.
Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52:e56–93.
Flowers CR, Seidenfeld J, Bow EJ, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31:794–810.
Sandherr M, Hentrich M, von Lilienfeld-Toal M, et al. Antiviral prophylaxis in patients with solid tumours and haematological malignancies – update of the Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Medical Oncology (DGHO). Ann Hematol. 2015;94:1441–50.
Cornely OA, Böhme A, Buchheidt D, et al. Primary prophylaxis of invasive fungal infections in patients with hematologic malignancies. Recommendations of the Infectious Diseases Working Party of the German Society for Haematology and Oncology. Haematologica. 2009;94:113–22.
Bower M, Palfreeman A, Alfa-Wali M, et al. British HIV association guidelines for HIV-associated malignancies 2014. HIV Med. 2014;15 Suppl 2:85–90.
Schneider MM, Hoepelman AI, Eeftinck Schattenkerk JK, et al. A controlled trial of aerosolized pentamidine or trimethoprim-sulfamethoxazole as primary prophylaxis against Pneumocystis carinii pneumonia in patients with human immunodeficiency virus infection. The Dutch AIDS Treatment Group. N Engl J Med. 1992;327:1836–41.
Hardy WD, Feinberg J, Finkelstein DM, et al. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021. N Engl J Med. 1992;327:1842–8.
El-Sadr WM, Luskin-Hawk R, Yurik TM, with Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA), et al. A randomized trial of daily and thrice-weekly trimethoprim-sulfamethoxazole for the prevention of Pneumocystis carinii pneumonia in human immunodeficiency virus-infected persons. Clin Infect Dis. 1999;29:775–83.
Pierce M, Crampton S, Henry D, et al. A randomized trial of clarithromycin as prophylaxis against disseminated mycobacterium avium complex infection in patients with advanced acquired immunodeficiency syndrome. N Engl J Med. 1996;335:384–91.
Havlir DV, Dube MP, Sattler FR, et al. Prophylaxis against disseminated Mycobacterium avium complex with weekly azithromycin, daily rifabutin, or both. California Collaborative Treatment Group. N Engl J Med. 1996;335:392–8.
Goldman M, Cloud GA, Wade KD, et al. A randomized study of the use of fluconazole in continuous versus episodic therapy in patients with advanced HIV infection and a history of oropharyngeal candidiasis: AIDS Clinical Trials Group Study 323/Mycoses Study Group Study 40. Clin Infect Dis. 2005;41:1473–80.
Cornely OA, Maertens J, Winston DJ, et al. Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia. N Engl J Med. 2007;356:348–59.
Swaika A, Paulus A, Miller KC, et al. Acyclovir prophylaxis against varicella zoster virus reactivation in multiple myeloma patients treated with bortezomib-based therapies: a retrospective analysis of 100 patients. J Support Oncol. 2012;10:155–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Hentrich, M. (2016). Infection Prophylaxis. In: Hentrich, M., Barta, S. (eds) HIV-associated Hematological Malignancies. Springer, Cham. https://doi.org/10.1007/978-3-319-26857-6_19
Download citation
DOI: https://doi.org/10.1007/978-3-319-26857-6_19
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-26855-2
Online ISBN: 978-3-319-26857-6
eBook Packages: MedicineMedicine (R0)