inPractice® - When to Initiate Antiretroviral Therapy in Patients With Acute Parasitic Infections

Guidelines on opportunistic infections recommend that antiretroviral-naive patients who present with an OI should start ART immediately if no effective antimicrobial is available to treat the OI (Management Guidelines)^{[CDC OI]} (Management Guidelines)^{[Panel 2008b]}
With OIs for which effective antimicrobial treatment is available, ART should be initiated within the first 2-4 weeks following initiation of antimicrobial therapy^{[Kaplan 2009; Panel 2008b; Zolopa 2009]}
Early ART initiation in the context of treatment of opportunistic infection does not necessarily increase the incidence of IRIS in patients with parasitic infections^{[Grant 2010]}