NIH Clinical Center

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Backgrounder


Clinical Center
National Institutes of Health

FOR RELEASE: July 27, 1995

Contact: Jan Lipkin
Communications
NIH Clinical Center
(301) 496-2563

NEW GUIDELINES ON PREVENTING OPPORTUNISTIC INFECTIONS IN PEOPLE WITH HIV AVAILABLE

The Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and the Infectious Disease Society of America (IDSA) have released guidelines on preventing opportunistic infections in people with the human immunodeficiency virus (HIV).

Opportunistic infections can cause life-threatening illnesses in people with weakened immune systems. About 80 percent of all people with HIV eventually develop one or more of these infections, according to Henry Masur, M.D., chief of the NIH Clinical Center's Critical Care Medicine Department.

"The guidelines are a milestone in providing up-to-date information to help medical practitioners better treat people with HIV," explains Dr. Masur, "thus increasing the quality and duration of life, and reducing the overall cost of care."

Dr. Masur, along with Jonathan Kaplan, M.D., CDC, and King Holmes, M.D., IDSA, headed the 85-member panel charged with developing the guidelines. Panel members represented a number of federal agencies, health-care organizations, research facilities, community groups, and individuals with HIV.

A major goal of the panel, Dr. Masur notes, is to make health-care providers and patients aware of advances in disease prevention so that people with HIV can benefit as soon as possible.

"Considerable progress has been made over the last five years in understanding how patients acquire opportunistic infections and what drugs and vaccines can reduce the likelihood that they will progress to clinical disease," Dr. Masur adds. "But, until now, there was no comprehensive, preventive treatment resource."

"The guidelines put into perspective many new drugs and drug strategies addressed in clinical trials by NIH, CDC, and private industry," Dr. Masur says. "These new trends have been presented only recently at meetings or published in journals, making it difficult for many practitioners and patients to remain abreast of important findings."

According to an editorial published by the panel in the July 26, 1995, edition of the Journal of the American Medical Association, one in four people infected with HIV is severely immunosuppressed and at greater risk for contracting serious infections.

About 100 microorganisms--viruses, bacteria, fungi and protozoa--can cause opportunistic infections in people with HIV. The guidelines specify drug therapies to help avert or mitigate 17 most commonly seen infections, including Pneumocystis carinii pneumonia, tuberculosis, and Mycobacterium avium complex. They establish a priority for drug regimens and immunizations while explaining specific ways to assess and avoid environmental exposure to other infections. They also detail risks associated with work, hobbies, pets and animals, food, water, and travel.

The guidelines stress early diagnosis of HIV infection and encourage HIV testing for all pregnant women. "Once HIV is diagnosed, preventing opportunistic infections is a critical part of the patient's health-care program," Dr. Masur adds.

The guidelines have been endorsed by PHS, IDSA, the American Academy of Pediatrics, the Infectious Diseases Society of Obstetrics and Gynecology, and the Society for Healthcare Epidemiologists of America. They were published in a supplement of the August 1995 issue of IDSA's journal, Clinical Infectious Diseases. A summary appeared in CDC's Morbidity and Mortality Weekly Report's Recommendations and Reports on July 14, 1995. Reprint packets are available from the CDC National AIDS Clearinghouse. Send requests to P.O. Box 6003, Rockville, Md. 20849-6003, or call 1-800-458-5231.

The HIV/AIDS Treatment Information Service can answer questions from the public and health-care providers regarding the content of these guidelines. Call 1-800-448-0440, 9 a.m. to 7 p.m., eastern time, Monday through Friday.

NOTE TO MEDIA: Panel members available for interviews:

Dr. Henry Masur
panel co-chair
chief, Critical Care Medicine
NIH Clinical Center
Contact: Office of Communications
301-496-2563

Dr. Neil Schram
private practitioner
member, CDC Advisory Committee on Prevention of HIV Infection
310-517-3228

Dr. Steven Schnittman
assistant director, Clinical Research Division of AIDS
National Institute of Allergy and Infectious Diseases
contact: Office of Communications
301-402-1663

David Barr
director, Treatment Education
Gay Men's Health Crisis
212-337-1904


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