IDSA Recommendations for Preventing and Managing Microsporidiosis in HIV-AIDS Preventing Chronic Microsporidiosis: • Because chronic microsporidiosis occurs primarily in persons with advanced immunodeficiency, initiation of ART before the patient becomes severely immunosuppressed should prevent the disease Managing Microsporidiosis: • Initiate or optimize ART with immune restoration to CD4 count >100 cells/mm3 • Severe dehydration, malnutrition, and wasting should be managed by fluid support and nutritional supplements • Anti-motility agents can be used for diarrhea control, if required For Gastrointestinal Infections Caused by Enterocytozoon bieneusi: • The best treatment option is ART and fluid support • No specific therapeutic agent is available for this infection. • Fumagillin 60 mg PO daily and TNP-470 are two agents that have some effectiveness, but neither agent is available in the United States. • Nitazoxanide may have some effect, but the efficacy is minimal in patients with low CD4 cell count, and cannot be recommended #Microsporidiosis #IDSA #Prevention #Treatment #management #opportunistic #infections #HIVAIDS #pharmacology
