ABSTRACT
Nearly 40 million people worldwide have been infected with human immunodeficiency virus (HIV) type 1 and more than 25 million have died. Highly active antiretroviral therapies (HAARTs) with multiple drugs-now widely used in the United States and highly effective-have greatly diminished the incidence of opportunistic infections in patients infected with HIV. Suppression of viral load to less than 50 copies/mL and maintenance of adequate CD4 lymphocyte counts (>500/µL [0.5×109/L]) are crucial. Opportunistic infections and malignancies are uncommon in HIV-infected patients with plasma HIV viral loads less than 10,000 copies/mL and CD4 counts greater than 200 to 500/µL (0.2-0.5×109/L). However, because of cost, compliance, lack of availability of treatment in certain parts of the world, drug resistance, drug toxicity, and drug-drug and drug-alternative substance interactions, not all patients with HIV infection receive adequate therapy. In immunosuppressed HIV-infected patients, multiple infections often occur simultaneously. Presentations may be typical or atypical, and there
