Updates to the Disseminated Mycobacterium Avium Complex Disease Section of the Adult and Adolescent Opportunistic Infections Guidelines

Updates to the Disseminated Mycobacterium Avium Complex Disease Section of the Adult and Adolescent Opportunistic Infections Guidelines

The Disseminated Mycobacterium avium Complex Disease section of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents has been updated. The panel updated the text and references throughout the section and made two key changes to their guidance: 

• Primary prophylaxis for MAC in people living with HIV who are on effective antiretroviral therapy (who are virally suppressed) is no longer recommended, regardless of CD4 cell count.
• Guidance has been added about drug-drug interactions and dosing when using rifabutin for treatment or prevention of MAC together with newer non-nucleoside reverse transcriptase inhibitors (rilpivirine, doravirine) and integrase strand transfer inhibitors (elvitegravir/cobicistat, bictegravir).

Updates to the Isosporiasis (Cystoisosporiasis) Section of the Pediatric Opportunistic Infections Guidelines

The Isosporiasis (Cystoisosporiasis) section of the Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children has been updated. There are no major changes to the guidance for the diagnosis and management of isosporiasis (cystoisosporiasis) in children and adolescents living with HIV. The section has been updated to reflect the new recommendation rating system and references were added.