Revisiting Co-trimoxazole Prophylaxis for African Adults in the Era of Antiretroviral Therapy: A Randomized Controlled Clinical Trial.
Matthew B LaurensRandy G MungwiraNginache NampotaOsward M NyirendaTitus H DivalaMaxwell KanjalaFelix A MkandawireLufina Tsirizani GalileyaWongani NyanguluEdson MwinjiwaMatthew DownsAmy TillmanTerrie E TaylorJane MallewaChristopher V PloweJoep J van OosterhoutMiriam K LauferPublished in: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2021)
Malawian adults with HIV who immune reconstituted on ART and continued co-trimoxazole prophylaxis experienced fewer deaths and WHO HIV/AIDS stage 3-4 events compared with prophylaxis discontinuation, although statistical significance was not achieved. Co-trimoxazole prevented a composite of death plus WHO HIV/AIDS stage 2-4 events. Given poor healthcare access and lack of routine viral load monitoring, co-trimoxazole prophylaxis should continue in adults on ART after immune reconstitution in sub-Saharan Africa. Clinical Trials Registration. NCT01650558.