According to the U.S. Department of Health and Human Services, maintaining the health of the immune system, using ARV therapy, is one of the best ways to reduce the risk of developing bacterial pneumonia.
HIV-positive people who have CD4 cell counts above 200 should talk with their doctors about receiving the 23-valent polysaccharide pneumococcal vaccine (PPV) if they do not recall receiving one during the past five years. While the effectiveness of this vaccine has not been established in clinical trials involving HIV-positive people, it is believed to offer some benefit to HIV-positive people with relatively healthy immune systems. People with HIV should consider being revaccinated every five years. PPV may also be offered to people with CD4 counts below 200, however, there is no evidence of benefit in this group unless they also initiate ARV
Receiving a flu shot (influenza vaccination) every year may also be a good idea for HIV-positive people. Many people who experience the flu, a viral infection, can also develop bacterial infections that can lead to pneumonia. Reducing the risk of the flu may also reduce the risk of bacterial pneumonia.
For HIV-positive people who experience frequent recurrences of bacterial respiratory infections, including pneumonia, the regular use of antibiotics may be necessary. However, treatment guidelines recommend against taking antibiotics regularly unless they are also being used to prevent either PCP pneumonia or Mycobacterium avium complex (MAC). This is because there is an increased risk of side effects or bacterial drug resistance if these drugs are used on a regular basis.
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