**8. Primary prophylaxis**

In high endemic areas (incidence >10 cases/100 patients-years), primary prophylaxis with Itraconazole 200 mg daily in HIV-infected patients with severe immunodepression reduce the frequency but not the mortality due to histoplasmosis [103], and thus is recommended for patients with CD4 count <150 cells/mm with high risk due to occupational exposure. The primary prophylaxis must be discontinued if the immune status is improving when CD4 counts attaint 150 cells/mm3 and remain stable for more than 6 months, and must be restarted when CD4 count decreases <150 cells/mm [93].
