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drip [108] (5C) It is recommended to carry out prophylaxis (preventive treatment) and treatment of non-tuberculous mycobacterioses (M.
kansasii) with a CD4 level 100 ?l-1 and undetectable HIV-VL for more than 3 months .
The following treatment is recommended for all HIV-infected patients with confirmed CNS cryptococcal infection [108,246,247,255] (5C): Stage of therapy Selection scheme Alternate Mode Induction therapy (duration 4–6 weeks or more) Amphotericin B 0.7-1.0 mg/kg 1 time per day IV drip ± fluconazole 200 mg 2 times a day Amphotericin B liposomal 3-4 mg/kg per day intravenously drip. Duration 4–6 weeks or more Consolidation Therapy fluconazole 400 mg per day (basic regimen) (8-10 weeks or until sanitation cerebrospinal fluid) itraconazole 200 mg twice a day.
(8 10 weeks) Maintenance therapy until the complete disappearance of clinical symptoms with a stable increase in the number of CD4 + lymphocytes > 100 cells / ml and undetectable VL for 3 months. fluconazole 200 mg per day orally. It is recommended for all HIV-infected patients to prescribe immunoglobulins upon confirmation of: immunodeficiency (with a replacement goal), idiopathic thrombocytopenia with an autoimmune mechanism of development, severe bacterial and viral secondary and concomitant diseases, autoimmune peripheral neuropathies [3,4,5,37] (5Ñ). Comments: the doses of drugs and the course of treatment depend on the degree of immunodeficiency, the severity of the patient's condition, as well as the drug of the immunoglobulin group. Human normal immunoglobulin is administered intravenously as an infusion. Re-introduction is carried out no earlier than 24 hours later. Surgical treatment Not indicated for the treatment of HIV infection. Treatment of surgical pathology is regulated by relevant clinical guidelines.
Other treatment There are currently no alternatives to ART for the treatment of HIV infection .
HIV infection does not require special diet therapy. Anesthesia is regulated by the relevant clinical guidelines and if indicated. [EC2] Change AZT to ZDV [EC3] [OAS4] Please check that it is not necessary to swap doses of sulph and trimethoprim with respect to the order of sulph and trimethoprim in the drug name [EC5] Co-trimoxazole [Sulfamethoxazole+Trimethoprim] 25/5 mg.
Rehabilitation Rehabilitation of patients is carried out according to the standards of treatment and rehabilitation of those secondary diseases that are detected in the patient, depending on the damage to the organs / systems of the body.? Prevention Prevention of HIV infection is carried out by state authorities, local authorities, employers, medical organizations, public associations through the development and implementation of a system of legal, economic and social measures aimed at preventing the emergence, spread and early detection of HIV infection. Prevention of HIV infection is provided by [175-180]: development and implementation of HIV prevention programs; implementation of measures for the prevention and early detection of HIV infection, dispensary observation of persons with HIV infection. A set of the following measures is recommended for the prevention of HIV infection [181- 189] (2A): informing the public about HIV infection and related diseases identifying in patients signs that indicate the presence of risky behavior and informing such patients about the means and methods for changing the degree of risk and the need for regular medical examination for HIV infection, as well as motivational counseling for such persons, in order to form their commitment to a healthy lifestyle, rejection of risky behavior; motivation of the serviced contingent to be tested for HIV infection, including informing citizens about the possibility of a medical examination for HIV infection with the provision of contact information for medical organizations where it is possible to carry out voluntary, including anonymous, examination for HIV infection; testing for HIV infection according to clinical indications; dispensary observation of patients with HIV infection; organizing and conducting a survey of the population for HIV infection, including screening.