When to Start Anti-HIV Drugs in Patients With Opportunistic Infections

Note: Participants who enrolled in this study prior to Version 3.0 will be offered and allowed to switch to FTC/TDF if they wish. However, participants under the age of 18 cannot receive FTC/TDF through this study. Inclusion Criteria for Step 1: HIV-1 infected Currently being treated for OI (including Pneumocystis carinii pneumonia [PCP]; cryptococcal meningitis; disseminated histoplasmosis; disseminated Mycobacterium avium complex [MAC]; cytomegalovirus [CMV] retinitis; CMV encephalitis; toxoplasmic encephalitis; other atypical non-tuberculous, non-MAC mycobacterial infections; or other serious, invasive BIs). Participants who have tuberculosis (TB) alone are ineligible for this study. Participants with bacterial pneumonia or serious BI must have a CD4 count less than 200 cells/mm3 within 30 days prior to study entry. Participants with other serious OIs, including other AIDS-defining and -related OIs for which appropriate therapy other than ART exists are eligible, pending investigator approval. Participants' current OI treatment must have been started within 14 days prior to study entry, but may have been discontinued prior to study entry. Able to take oral medications Parent or guardian willing to provide informed consent, if applicable Willing to use acceptable methods of contraception Exclusion Criteria for Step 1: Any ART within 8 weeks prior to study entry 31 or more days of any ARV within 6 months prior to entry History of more than one virologic, immunologic, or clinical treatment failure while on a HAART regimen, or a history of more than one regimen change for unknown reasons Systemic cancer chemotherapy within 30 days prior to study entry Immunomodulators within 30 days prior to study entry, including growth factors, immune globulin, interleukins, and interferons (unless for hepatitis C virus or Kaposi's sarcoma) Investigational ARV agents at study entry Systemic investigational agents (except ARV drugs) within 30 days prior to study entry will be allowed at the study official's discretion Anticipated use of certain medications Kidney failure requiring dialysis Current drug or alcohol use that, in the opinion of the study official, would interfere with the study Treatment for current, first-treated, and diagnosed OI or BI for more than 14 days prior to study entry Known resistance to ART that prohibits administration of an effective ART regimen Current OI has recurred within 90 days prior to study entry. Recurrent BIs are not excluded. Pregnant or breastfeeding