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infectious-disease immunology

HIV Opportunistic Infection Risk (CD4-Based)

Predicts risk of specific opportunistic infections by CD4 count threshold. Guides prophylaxis and diagnostic priorities in HIV-positive patients.

Score interpretation

CD4 >500 or well-controlled on ART

→ Standard HIV monitoring; routine vaccinations (avoid live if CD4 <200); no specific OI prophylaxis needed; 6-monthly HIV clinic review

CD4 200-500: Moderate immune suppression

→ Annual OI screen; pneumococcal vaccine; TB screen (IGRA); routine dental; STI screening; ensure ART compliance; 3-monthly monitoring if declining

CD4 <200: High risk OIs

→ PCP prophylaxis: co-trimoxazole 960mg daily (dapsone if intolerant); CD4 <100: add toxoplasma prophylaxis (co-trimoxazole covers both); CD4 <50: MAC prophylaxis (azithromycin 1.2g weekly); CMV and cryptococcal antigen screening; urgent ART if not started; ID specialist

Interpretation bands for the HIV OI Risk by CD4. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.