HIV CD4 Opportunistic Infection Risk
Stratifies risk of AIDS-defining opportunistic infections based on CD4 count. Guides prophylaxis decisions and clinical monitoring.
Score interpretation
CD4 above 500 cells/µL.
→ Standard ART; routine monitoring; no prophylaxis needed
CD4 200–500 cells/µL.
→ Optimise ART adherence; watch for bacterial infections and TB
CD4 100–200 cells/µL.
→ Start co-trimoxazole prophylaxis; screen for TB and toxoplasma
CD4 50–100 cells/µL: toxoplasma prophylaxis if toxoplasma IgG-positive, as well as PCP prophylaxis.
→ Co-trimoxazole prophylaxis covers PCP and toxoplasma; cryptococcal antigen screening; start or optimise ART promptly.
CD4 below 50 cells/µL: risk of CMV, MAC, PCP and cryptococcal disease.
→ Start ART promptly; PCP / toxoplasma prophylaxis; MAC prophylaxis (azithromycin) only if ART is not started immediately; dilated eye examination for CMV retinitis; cryptococcal antigen screening.
Interpretation bands for the HIV CD4 OI Risk. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Anti-D (Rh₀) Immunoglobulin · Immunoglobulin (Rh Prophylaxis)
- Cefuroxime · Second-Generation Cephalosporin — Respiratory / Surgical Prophylaxis
- Benzathine Benzylpenicillin · Long-Acting Penicillin — Syphilis / Rheumatic Fever Prophylaxis
- Micafungin · Echinocandin Antifungal — Invasive Candidiasis / Prophylaxis in HSCT
- Posaconazole · Extended-Spectrum Triazole — Aspergillus / Mucor / Prophylaxis in Immunocompromised
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.