Opportunistic infections (OIs) are infections that occur more frequently or are more severe in people with weakened immune systems.

Common Opportunistic Infections:
Tuberculosis, Pneumocystis pneumonia (PCP), Candidiasis, Toxoplasmosis, Cytomegalovirus (CMV), Cryptococcal meningitis, and Mycobacterium avium complex (MAC).

Risk Factors:
Low CD4 count (especially <200 cells/mm┬│), not taking ART, poor adherence to treatment, and other immunosuppressive conditions increase OI risk.

Prevention Strategies:
Starting ART promptly, maintaining viral suppression, prophylactic medications for certain OIs, vaccinations, and avoiding exposure to pathogens.

Prophylaxis Guidelines:
CD4 <200: PCP prophylaxis with trimethoprim-sulfamethoxazole
CD4 <100: Toxoplasmosis prophylaxis
CD4 <50: MAC prophylaxis

Treatment Approaches:
Specific antimicrobial therapy for diagnosed OIs, continuing ART during OI treatment, and immune reconstitution inflammatory syndrome (IRIS) management.

Immune Reconstitution:
As immune function improves with ART, some people may experience IRIS - inflammatory responses to previously subclinical infections.

Long-term Management:
Regular monitoring, maintaining ART adherence, and prophylaxis discontinuation when CD4 count improves sustainably.