Which of the following is NOT generally considered an opportunistic infection associated with HIV?

Histoplasmosis is not typically categorized as an opportunistic infection specifically associated with HIV. While individuals with HIV may be more susceptible to a range of infections due to their compromised immune systems, histoplasmosis is primarily seen in those with significant immunosuppression or in certain endemic regions where the fungus is common.

In contrast, Pneumocystic pneumonia, toxoplasmosis, and Kaposi's sarcoma are well-recognized opportunistic infections linked to HIV. Pneumocystic pneumonia is caused by the fungus Pneumocystis jirovecii and is common in patients whose CD4 T-cell counts fall below critical levels. Toxoplasmosis is often associated with reactivation of dormant infections in immunocompromised patients and can lead to severe neurological complications. Kaposi's sarcoma, while not an infection, is a malignancy that is frequently seen in people with advanced HIV and reflects the opportunistic nature of the pathologies arising in this context.

Therefore, the classification of histoplasmosis as not generally considered an opportunistic infection specifically in HIV patients underlines its distinction from the other conditions listed, which are more directly associated with the opportunistic infection profile in immunocompromised states.