No need for secondary Pneumocystis jirovecii pneumonia prophylaxis in adult people living with HIV from Europe on ART with suppressed viraemia and a CD4 cell count greater than 100 cells/µL.
Andrew AtkinsonJose M MiroAmanda MocroftPeter ReissOle KirkPhilippe MorlatJade GhosnChristoph StephanCristina MussiniAnastasia AntoniadouKatja DoerholtEnrico GirardiStéphane De WitDavid KrausMarcel ZwahlenHansjakob Furrernull nullPublished in: Journal of the International AIDS Society (2021)
HIV viraemia importantly affects the risk of recurrent PjP. In virologically suppressed patients on ART with CD4 counts of 100 to 200/µL, the incidence of PjP off prophylaxis is below 10/1000 py. Secondary PjP prophylaxis may be safely withheld in such patients. While European guidelines recommend discontinuing secondary PjP prophylaxis only if CD4 counts rise above 200 cells/mL, the latest US Guidelines consider secondary prophylaxis discontinuation even in patients with a CD4 count above 100 cells/µL and suppressed viral load. Our results strengthen and support this US recommendation.
Keyphrases
- induced apoptosis
- end stage renal disease
- hiv infected
- cell cycle arrest
- newly diagnosed
- chronic kidney disease
- ejection fraction
- antiretroviral therapy
- peripheral blood
- peritoneal dialysis
- prognostic factors
- cell death
- signaling pathway
- oxidative stress
- stem cells
- endoplasmic reticulum stress
- clinical practice
- hiv aids
- hiv positive
- bone marrow
- young adults
- hepatitis c virus
- extracorporeal membrane oxygenation