Is it safe to discontinue primary Pneumocystis jiroveci pneumonia prophylaxis in patients with virologically suppressed HIV infection and a CD4 cell count <200 cells/microL?

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
A MocroftHansjakob Furrer

Abstract

Current guidelines suggest that primary prophylaxis for Pneumocystis jiroveci pneumonia (PcP) can be safely stopped in human immunodeficiency virus (HIV)-infected patients who are receiving combined antiretroviral therapy (cART) and who have a CD4 cell count >200 cells/microL. There are few data regarding the incidence of PcP or safety of stopping prophylaxis in virologically suppressed patients with CD4 cell counts of 101-200 cells/microL. The Opportunistic Infections Project Team of the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) included data from 23,412 patients from 12 European cohorts who started taking cART after 1997. Poisson regression was used to model incidence rate ratios (IRRs) of primary PcP. There were 253 PcP cases during 107,016 person-years of follow-up (PYFU). Prophylaxis significantly reduced the incidence of PcP among patients with current CD4 cell counts 100 cells/microL (adjusted IRR, 0.41; 95% confidence interval [CI], 0.27-0.60) but not significantly among those with current CD4 cell counts of 101-200 cells/microL (adjusted IRR, 0.63; 95% CI, 0.34-1.17). The incidence of PcP among patients who had a current CD4 cell count of 100-200 cells/microL, who had a viral load <...Continue Reading

Associated Clinical Trials

Citations

Mar 17, 2012·American Journal of Respiratory and Critical Care Medicine·Ching-Lan Lu, Chien-Ching Hung
Jun 10, 2011·Proceedings of the American Thoracic Society·Laurence HuangUNKNOWN Lung HIV Study
Apr 3, 2012·Medical Mycology Journal·Takahiro Aoki, Shinichi Oka
May 17, 2014·AIDS Patient Care and STDs·Bienvenido G YangcoUNKNOWN HIV Outpatient Study Investigators
May 10, 2016·JCI Insight·Eileen P ScullyMarcus Altfeld
Jan 15, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Howard B GaleVirginia L Kan
Jan 15, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Paul E Sax
Apr 6, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Paul G BarnettSteven M Asch
Aug 26, 2016·The Journal of Infectious Diseases·Hansjakob Furrer
Mar 19, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Marie-Charlotte LoronDominique Bertrand
Jan 12, 2017·Pediatric Blood & Cancer·Matthijs D KruizingaRobbert G M Bredius
Apr 18, 2014·Journal of the International Association of Providers of AIDS Care·Anandit MuSimon Paul
Sep 16, 2016·Journal of the International Association of Providers of AIDS Care·Xia LinJacek Skarbinski
Mar 15, 2018·Journal of the International Association of Providers of AIDS Care·Henry AnyimaduSharon Mannheimer
Nov 16, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Olivia VeitUNKNOWN Swiss HIV Cohort Study
Jul 12, 2017·Journal of the International AIDS Society·Lukas FennerUNKNOWN International Epidemiology Database to Evaluate AIDS in Southern Africa (IeDEA-SA)
Sep 4, 2015·Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine·Sadatomo Tasaka
Jul 27, 2018·Journal of Thoracic Imaging·Cristina Vazquez GuillametRodrigo Vazquez Guillamet
Jun 22, 2019·AIDS·Agnieszka WójtowiczUNKNOWN Swiss HIV Cohort Study
Aug 8, 2017·Expert Review of Anti-infective Therapy·Yu-Shan HuangChien-Ching Hung
Sep 26, 2019·Expert Review of Anti-infective Therapy·Catia CillónizJosé M Miro
Jul 14, 2020·American Journal of Physiology. Renal Physiology·Xuan WangJohn Cijiang He
Nov 20, 2016·International Journal of Epidemiology·Geneviève ChêneStéphane De Wit
Feb 6, 2020·Therapeutic Advances in Infectious Disease·James CutrellRoger Bedimo
Nov 25, 2018·Journal of Fungi·P Lewis WhiteMatthijs Backx
May 26, 2020·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andrew AtkinsonUNKNOWN Opportunistic Infections Project Working Group of the Collaboration of Observational HIV Epidemiological Research Europe (CO
Oct 7, 2011·Expert Review of Anti-infective Therapy·Laura Waters, Caroline A Sabin
Jun 13, 2021·Journal of the International AIDS Society·Andrew AtkinsonUNKNOWN Opportunistic Infections Working Group of the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) st

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