Long-term safety of discontinuation of secondary prophylaxis against Pneumocystis pneumonia: prospective multicentre study

Details

Serval ID
serval:BIB_E6F04B87DD48
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Long-term safety of discontinuation of secondary prophylaxis against Pneumocystis pneumonia: prospective multicentre study
Journal
AIDS
Author(s)
Zellweger  C., Opravil  M., Bernasconi  E., Cavassini  M., Bucher  H. C., Schiffer  V., Wagels  T., Flepp  M., Rickenbach  M., Furrer  H.
ISSN
0269-9370 (Print)
Publication state
Published
Issued date
10/2004
Volume
18
Number
15
Pages
2047-53
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Oct 21
Abstract
OBJECTIVES: To assess the long-term safety of discontinuation of secondary anti-Pneumocystis prophylaxis in HIV-infected adults treated with antiretroviral combination therapy and who have a sustained increase in CD4 cell counts. DESIGN: Prospective observational multicentre study. PATIENTS AND METHODS: The incidence of P. jirovecii pneumonia after discontinuation of secondary prophylaxis was studied in 78 HIV-infected patients on antiretroviral combination therapy after they experienced a sustained increase in CD4 cell counts to at least 200 x 10(6) cells/l and 14% of total lymphocytes measured twice at least 12 weeks apart. RESULTS: Secondary prophylaxis was discontinued at a median CD4 cell count of 380 x 10(6) cells/l. The median follow-up period after discontinuation of secondary prophylaxis was 40.2 months, yielding a total of 235 person-years of follow-up. No cases of recurrent P. jirovecii pneumonia occurred during this period. The incidence was thus 0 per 100 person-years with a 95% upper of confidence limit of 1.3 cases per 100 patient-years. CONCLUSIONS: Discontinuation of secondary prophylaxis against P. jirovecii pneumonia is safe even in the long term in patients who have a sustained immunologic response on antiretroviral combination therapy.
Keywords
AIDS-Related Opportunistic Infections/complications/*prevention & control Adult *Antiretroviral Therapy, Highly Active CD4 Lymphocyte Count Cohort Studies Female HIV Infections/*drug therapy Humans Male Middle Aged Pneumonia, Pneumocystis/complications/*prevention & control Prospective Studies Recurrence/prevention & control Withholding Treatment
Pubmed
Web of science
Create date
29/01/2008 8:52
Last modification date
20/08/2019 16:10
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