TY - JOUR
T1 - Discontinuation of secondary prophylaxis for Pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients
T2 - A randomized trial by the CIOP Study Group
AU - Mussini, Cristina
AU - Pezzotti, Patrizio
AU - Antinori, Andrea
AU - Borghi, Vanni
AU - D'Arminio Monforte, Antonella
AU - Govoni, Alessandra
AU - De Luca, Andrea
AU - Ammassari, Adriana
AU - Mongiardo, Nicola
AU - Cerri, Maria Chiara
AU - Bedini, Andrea
AU - Beltrami, Cristina
AU - Ursitti, Maria Alessandra
AU - Bini, Teresa
AU - Cossarizza, Andrea
AU - Esposito, Roberto
PY - 2003/3/1
Y1 - 2003/3/1
N2 - This subgroup analysis assessing secondary prophylaxis for Pneumocystis carinii pneumonia (PCP) describes a multicenter, open-labeled, randomized, controlled trial evaluating the discontinuation of PCP prophylaxis. The main inclusion criterion was a history of PCP and an increase in the CD4 cell count to >200 cells/μL associated with receipt of highly active antiretroviral therapy for ≥3 months. The primary end point was the development of definitive or presumptive PCP. A total of 146 patients were enrolled (77 in the treatment discontinuation arm). After >2 years, 1 definitive and 1 presumptive case of PCP were observed, both of which occurred in patients who discontinued therapy. In most patients, secondary prophylaxis for PCP can be safely discontinued after potent antiretroviral therapy is initiated, but the threshold of >200 CD4 cells/μL may not be considered absolutely safe. Patients who present with symptoms after discontinuation of secondary prophylaxis should be evaluated for PCP despite high CD4 count and complete virus suppression.
AB - This subgroup analysis assessing secondary prophylaxis for Pneumocystis carinii pneumonia (PCP) describes a multicenter, open-labeled, randomized, controlled trial evaluating the discontinuation of PCP prophylaxis. The main inclusion criterion was a history of PCP and an increase in the CD4 cell count to >200 cells/μL associated with receipt of highly active antiretroviral therapy for ≥3 months. The primary end point was the development of definitive or presumptive PCP. A total of 146 patients were enrolled (77 in the treatment discontinuation arm). After >2 years, 1 definitive and 1 presumptive case of PCP were observed, both of which occurred in patients who discontinued therapy. In most patients, secondary prophylaxis for PCP can be safely discontinued after potent antiretroviral therapy is initiated, but the threshold of >200 CD4 cells/μL may not be considered absolutely safe. Patients who present with symptoms after discontinuation of secondary prophylaxis should be evaluated for PCP despite high CD4 count and complete virus suppression.
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U2 - 10.1086/367659
DO - 10.1086/367659
M3 - Article
C2 - 12594647
AN - SCOPUS:0037371846
VL - 36
SP - 645
EP - 651
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 5
ER -