Pneumocystis jirovecii Pneumonia: When Can Prophylaxis Be Discontinued?

Stopping PCP prophylaxis appears to be safe for patients on suppressive antiretroviral therapy who have CD4 counts of 101 to 200 cells/mm³.

Potent combination antiretroviral therapy (ART) has greatly diminished the risk for most AIDS-related opportunistic infections (OIs), including Pneumocystis jirovecii pneumonia (PCP). However, the recommendations for primary and secondary PCP prophylaxis rely heavily on studies pre-dating the current HIV treatment era. Are the old CD4-cell count prophylaxis thresholds still warranted for patients with virologic suppression on ART?

To explore this issue, researchers from the European-based COHERE group examined the rate of primary PCP in the potent ART era, focusing on outcomes among patients who discontinued primary PCP prophylaxis at CD4 counts ≤200 cells/mm³. They analyzed data for 23,412 patients who started potent ART after 1997 and had …

Reviewing Author

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Keith Henry, MD

Disclosures

Consultant/Advisory BoardViiV Advisory Board

Editorial BoardsJAIDS: Journal of Acquired Immune Deficiency Syndromes

Pneumocystis jirovecii Pneumonia: When Can Prophylaxis Be Discontinued?

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Reviewing Author