Discontinuing or withholding primary prophylaxis against Mycobacterium avium in patients on successful antiretroviral combination therapy. The Swiss HIV Cohort Study
Details
Serval ID
serval:BIB_64766ACD2516
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Discontinuing or withholding primary prophylaxis against Mycobacterium avium in patients on successful antiretroviral combination therapy. The Swiss HIV Cohort Study
Journal
AIDS
ISSN
0269-9370 (Print)
Publication state
Published
Issued date
07/2000
Volume
14
Number
10
Pages
1409-12
Notes
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Jul 7
Multicenter Study
Research Support, Non-U.S. Gov't --- Old month value: Jul 7
Abstract
OBJECTIVE: To assess the safety of discontinuing or withholding primary prophylaxis against disseminated Mycobacterium avium infection (MAC) in HIV infected patients on successful antiretroviral combination therapy. SETTING: National prospective multicentre cohort study. DESIGN: HIV-infected patients were eligible for the analysis if: (i) they had a history of at least two CD4 cell counts < 50 x 10(6)/l; (ii) they had never had MAC; (iii) they had discontinued or never begun primary prophylaxis against MAC; (iv) they received antiretroviral therapy and demonstrated an increase in CD4 cell counts to > or = 100 x 10(6)/l that was sustained for at least 12 weeks. From this time point until last follow-up, incidence of disseminated MAC disease was measured, and 99% confidence intervals were calculated assuming a Poisson distribution of events. RESULTS: Two-hundred and fifty-three patients (22.5% female; median age, 37 years, 30% injecting drug users) were eligible for analysis. Sixty-six per cent were in Centers for Disease Control and Prevention (CDC) stage C, and 28% were in CDC stage B. Their median nadir CD4 cell count was 10 x 10(6)/l, the median duration of CD4 cell count < 50 x 10(6)/l was 12 months. During a total follow-up of 364.3 patient-years there was no case of disseminated MAC. The one-sided 99% confidence limit for incidence density of MAC was 1.3 per 100 person-years. CONCLUSION: Discontinuing or withholding primary prophylaxis against MAC is safe in patients who have a sustained increase in their CD4 cell count to > or = 100 x 10(6)/l.
Keywords
AIDS-Related Opportunistic Infections/complications/*prevention & control
Adult
Aged
Anti-HIV Agents/*administration & dosage
CD4 Lymphocyte Count
Cohort Studies
Female
HIV Infections/*drug therapy/immunology
Humans
Male
Middle Aged
Mycobacterium avium-intracellulare Infection/complications/*prevention &
control
Switzerland
Pubmed
Web of science
Create date
25/01/2008 15:46
Last modification date
20/08/2019 15:20