Discontinuation of chemoprophylaxis against Pneumocystis carinii pneumonia in patients with HIV infection. HIV Outpatient Study (HOPS) Investigators.

Abstract

BACKGROUND:

HIV-infected patients with sustained immunologic improvement from antiretroviral therapy may be able to discontinue chemoprophylaxis against Pneumocystis carinii pneumonia (PCP).

OBJECTIVE:

To compare PCP incidence in HIV-infected patients who had sustained CD4+ lymphocyte counts greater than 200 cells/mm3 and who either discontinued or continued PCP prophylaxis.

DESIGN:

Nonrandomized prospective cohort study.

SETTING:

10 HIV clinics in eight U.S. cities.

PATIENTS:

146 patients had follow-up visits for a mean of 18.2 months after discontinuation of PCP prophylaxis, and 345 patients who continued PCP prophylaxis had follow-up visits for a mean of 14.0 months.

MEASUREMENTS:

Incidence of PCP.

RESULTS:

Patients who discontinued PCP prophylaxis had higher maximum and minimum CD4+ cell counts and lower vira loads than patients who continued PCP prophylaxis. Pneumocystis carinii pneumonia did not develop in either group (upper 95% exact binomial confidence limit of incidence for those who discontinued PCP prophylaxis, 2.3/100 person-years).

CONCLUSIONS:

Discontinuation of PCP chemoprophylaxis may be appropriate for some HIV-infected ambulatory patients.

• Authors: B G Yangco, J C Von Bargen, A C Moorman, S D Holmberg
• Journal: Annals of internal medicine (Ann Intern Med) Vol. 132 Issue 3 Pg. 201-5 (Feb 01 2000) ISSN: 0003-4819 [Print] United States
• PMID: 10651600 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Anti-HIV Agents
• Antifungal Agents
• Protease Inhibitors

Topics

• AIDS-Related Opportunistic Infections (epidemiology, prevention & control)
• Anti-HIV Agents (therapeutic use)
• Antifungal Agents (therapeutic use)
• CD4 Lymphocyte Count
• Chemoprevention
• Drug Therapy, Combination
• Female
• HIV Infections (drug therapy, immunology, virology)
• Humans
• Male
• Pneumonia, Pneumocystis (epidemiology, prevention & control)
• Prospective Studies
• Protease Inhibitors (therapeutic use)
• Viral Load