Table 2

Treatment and prophylaxis of cryptoccocosis and toxoplasmosis in HIV infection

First choice Alternative
Cryptoccocosis
Acute infectionAmphotericine B, 0.7 mg/(kg.day) iv and flucytosine, 100 mg/(kg.day) orally or iv in 4 divided doses for 2 weeks, then fluconazole, 400 mg orally four times daily for 8 weeksFluconazole, 400 mg orally four times daily for 10 weeks, or
Fluconazole 200–400 mg orally four times daily for 10 weeks and flucytosine 150 mg/(kg.day) orally or iv in 4 divided doses for 2 weeks
Suppressive therapyFluconazole 200 mg orally four times dailyAmphotericine B, 0.6–1.0 mg/kg iv four times weekly, or
Itraconazole, 200 mg orally four times daily
Toxoplasmosis
Acute infectionPyrimethamine 100–200 mg loading dose (2 days), then 50–100 mg orally four times daily plus folinic acid 10 mg orally four times daily+ sulfadiazine 4–8 g orally four times daily for at least 6 weeksPyrimethamine plus acid folinic plus clindamycin 900–1200 mg iv four times/6h or 300–450 mg orally four times/6h for at least 6 weeks, or
Trimethoprim, 160 mg plus sulfamethoxazole, 800 mg/8h orally or iv for at least 6 weeks
Suppressive therapyPyrimethamine 25–75 mg orally four times daily plus folinic acid 10 mg orally four times daily + sulfadiazine 500–1000 mg orally four times/6 hPyrimethamine plus acid folinic plus clindamycin 300–450 mg orally four times/6h, or
Trimethoprim, 160 mg plus sulfamethoxazole, 800 mg orally four times daily
Prophylaxis (patients with positive IgG serology and CD4 count <100/mm3)Trimethoprim, 160 mg plus sulfamethoxazole, 800 mg orally four times dailyDapsone 50 mg/day plus pyrimethamine 50 mg/week plus folinic acid 25 mg/week