Monitoring
Monitoring during therapy should focus on evaluating for response to treatment, drug toxicities, and immune reconstitution inflammatory syndrome (IRIS).[130]
If Pneumocystis pneumonia (PCP) appears to be clinically worsening after starting combination antiretroviral therapy (ART), it is important to rule out PCP treatment failure, drug reaction, new infection, malignancy, or another process, such as congestive heart failure, before diagnosing IRIS. Early initiation of ART (within 2 weeks) compared with initiation of ART after the end of treatment was associated with lower mortality risk in one study of non-intensive care unit patients with PCP, and early ART initiation is recommended.[131]
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