Bienvenido G. Yangco, MD, MPH; Jennifer C. Von Bargen, BS; Anne C. Moorman, BSN, MPH; Scott D. Holmberg, MD, MPH; HIV Outpatient Study (HOPS) Investigators*
Yangco BG, Bargen JCV, Moorman AC, Holmberg SD, HIV Outpatient Study (HOPS) Investigators*. Discontinuation of Chemoprophylaxis against Pneumocystis carinii Pneumonia in Patients with HIV Infection. Ann Intern Med. 2000;132:201-205. doi: 10.7326/0003-4819-132-3-200002010-00005
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Published: Ann Intern Med. 2000;132(3):201-205.
HIV-infected patients with sustained immunologic improvement from antiretroviral therapy may be able to discontinue chemoprophylaxis against Pneumocystis carinii pneumonia (PCP).
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.
Nonrandomized prospective cohort study.
10 HIV clinics in eight U.S. cities.
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.
Incidence of PCP.
Patients who discontinued PCP prophylaxis had higher maximum and minimum CD4+ cell counts and lower viral 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).
Discontinuation of PCP chemoprophylaxis may be appropriate for some HIV-infected ambulatory patients.
*For members of the HIV Outpatient Study Investigators, see Appendix.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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