IDSA Recommendations for Preventing and Managing Microsporidiosis in HIV-AIDS
Preventing Chronic Microsporidiosis:
• Because chronic microsporidiosis occurs primarily in persons with advanced immunodeficiency, initiation of ART before the patient becomes severely immunosuppressed should prevent the disease
• Initiate or optimize ART with immune restoration to CD4 count >100 cells/mm3
• Severe dehydration, malnutrition, and wasting should be managed by fluid support and nutritional supplements
• Anti-motility agents can be used for diarrhea control, if required
For Gastrointestinal Infections Caused by Enterocytozoon bieneusi:
• The best treatment option is ART and fluid support
• No specific therapeutic agent is available for this infection.
• Fumagillin 60 mg PO daily and TNP-470 are two agents that have some effectiveness, but neither agent is available in the United States.
• Nitazoxanide may have some effect, but the efficacy is minimal in patients with low CD4 cell count, and cannot be recommended
#Microsporidiosis #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology