Is It Safe to Discontinue Primary Pneumocystis jiroveci Pneumonia Prophylaxis in Patients with Virologically Suppressed HIV Infection and a CD4 Cell Count <200 Cells/μL?
Is It Safe to Discontinue Primary Pneumocystis jiroveci Pneumonia Prophylaxis in Patients with Virologically Suppressed HIV Infection and a CD4 Cell Count <200 Cells/μL?
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DOI：
10.1086/655761
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发表时间：
2010-09-01
影响因子：
11.8
通讯作者：
Furrer, Hansjakob
中科院分区：
文献类型：
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作者：
Furrer, Hansjakob
背景目前的指南建议，在接受联合抗逆转录病毒治疗（cART）和CD 4细胞计数>200个细胞/μ L的人类免疫缺陷病毒（HIV）感染患者中，可以安全地停止耶氏肺孢子虫肺炎（PcP）的一级预防。有很少的数据关于发生率的PcP或停止预防性治疗的病毒学抑制患者的CD 4细胞计数为101-200细胞/μ L的安全性。欧洲观察性艾滋病流行病学研究协作组织（COHERE）的艾滋病感染项目小组纳入了来自12个欧洲队列的23，412名患者的数据，这些患者在1997年后开始接受cART。采用Poisson回归模型对原发性前列腺癌的发病率比（IRR）进行建模。在107，016人年的随访（PYFU）期间，共有253例PcP病例。预防性治疗显著降低了当前CD 4细胞计数的患者中PcP的发生率
Background. Current guidelines suggest that primary prophylaxis for Pneumocystis jiroveci pneumonia (PcP) can be safely stopped in human immunodeficiency virus (HIV)-infected patients who are receiving combined antiretroviral therapy (cART) and who have a CD4 cell count >200 cells/mu L. There are few data regarding the incidence of PcP or safety of stopping prophylaxis in virologically suppressed patients with CD4 cell counts of 101-200 cells/mu L.Methods. The Opportunistic Infections Project Team of the Collaboration of Observational HIV Epidemiological Research in Europe (COHERE) included data from 23,412 patients from 12 European cohorts who started taking cART after 1997. Poisson regression was used to model incidence rate ratios (IRRs) of primary PcP.Results. There were 253 PcP cases during 107,016 person-years of follow-up (PYFU). Prophylaxis significantly reduced the incidence of PcP among patients with current CD4 cell counts