Document Detail

Long-term safety of discontinuation of secondary prophylaxis against Pneumocystis pneumonia: prospective multicentre study.
MedLine Citation:
PMID:  15577626     Owner:  NLM     Status:  MEDLINE    
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.
Claudine Zellweger; Milos Opravil; Enos Bernasconi; Matthias Cavassini; Heiner C Bucher; Veronique Schiffer; Thomas Wagels; Markus Flepp; Martin Rickenbach; Hansjakob Furrer;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  18     ISSN:  0269-9370     ISO Abbreviation:  AIDS     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-12-03     Completed Date:  2005-04-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  2047-53     Citation Subset:  IM; X    
Division of Infectious Diseases, University Hospital of Berne, Berne, Switzerland.
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MeSH Terms
AIDS-Related Opportunistic Infections / complications,  prevention & control*
Antiretroviral Therapy, Highly Active*
CD4 Lymphocyte Count
Cohort Studies
HIV Infections / drug therapy*
Middle Aged
Pneumonia, Pneumocystis / complications,  prevention & control*
Prospective Studies
Recurrence / prevention & control
Withholding Treatment

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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