Discontinuation of primary prophylaxis for Pneumocystis carinii pneumonia and toxoplasmic encephalitis in human immunodeficiency virus type I-Infected patients: The changes in opportunistic prophylaxis study

Cristina Mussini, Patrizio Pezzotti, Alessandra Govoni, Vanni Borghi, Andrea Antinori, Antonella D'Arminio Monforte, Andrea De Luca, Nicola Mongiardo, Maria Chiara Cerri, Francesco Chiodo, Ercole Concia, Lucio Bonazzi, Mauro Moroni, Luigi Ortona, Roberto Esposito, Andrea Cossarizza, Bruno De Rienzo

Research output: Contribution to journalArticle

Abstract

A multicenter open, randomized, controlled trial was conducted to determine whether primary prophylaxis for Pneumocystis carinii pneumonia and toxoplasmic encephalitis can be discontinued in patients infected with human immunodeficiency virus type 1 (HIV-1) whose CD4+ T cell counts have increased to >200 cells/mm3 (and who have remained at this level for at least 3 months) as a result of highly active antiretroviral therapy (HAART). Patients were randomized to either the discontinuation arm (i.e., those who discontinued prophylaxis; n = 355) or to the continuation arm (n = 353); the 2 arms of the study were similar in terms of demographic, clinical, and immunovirologic characteristics. During the median follow-ups of 6.4 months- (discontinuation arm) and 6.1 months (continuation arm) and with a total of 419 patient-years, no patient developed P. carinii pneumonia or toxoplasmic encephalitis. The results of this study strongly indicate that primary prophylaxis for P. carinii pneumonia and toxoplasmic encephalitis can be safely discontinued in patients whose CD4+ T cell counts increase to >200 cells/mm3 during HAART.

Original languageEnglish
Pages (from-to)1635-1642
Number of pages8
JournalJournal of Infectious Diseases
Volume181
Issue number5
DOIs
Publication statusPublished - 2000

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ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Mussini, C., Pezzotti, P., Govoni, A., Borghi, V., Antinori, A., D'Arminio Monforte, A., De Luca, A., Mongiardo, N., Cerri, M. C., Chiodo, F., Concia, E., Bonazzi, L., Moroni, M., Ortona, L., Esposito, R., Cossarizza, A., & De Rienzo, B. (2000). Discontinuation of primary prophylaxis for Pneumocystis carinii pneumonia and toxoplasmic encephalitis in human immunodeficiency virus type I-Infected patients: The changes in opportunistic prophylaxis study. Journal of Infectious Diseases, 181(5), 1635-1642. https://doi.org/10.1086/315471