Risk for Preventable Opportunistic Infections in Persons with AIDS after Antiretroviral Therapy Increases CD4+ T Lymphocyte Counts above Prophylaxis Thresholds

To determine incidence and risk for preventable opportunistic infections (Pneumocystis carinii pneumonia [PCP] and disseminated Mycobacterium avium—complex [MAC] infection) in persons whose CD4+ T lymphocyte counts had increased by ⩾100 cells/µL to exceed the threshold of risk and in persons whose C...

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Bibliographic Details
Published in:The Journal of infectious diseases 2000-08, Vol.182 (2), p.611-615
Main Authors: Dworkin, Mark S., Hanson, Debra L., Kaplan, Jonathan E., Jones, Jeffrey L., Ward, John W.
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Acquired Immunodeficiency Syndrome - drug therapy
AIDS
AIDS/HIV
Antiretrovirals
Biological and medical sciences
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes - cytology
Concise Comunications
Disease risk
HIV
Human viral diseases
Humans
Incidence
Infections
Infectious diseases
Medical sciences
Mycobacterium avium complex
Mycobacterium avium-intracellulare Infection - etiology
Opportunistic infections
Pneumocystis pneumonia
Pneumonia, Pneumocystis - etiology
Preventive medicine
Proportional Hazards Models
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:To determine incidence and risk for preventable opportunistic infections (Pneumocystis carinii pneumonia [PCP] and disseminated Mycobacterium avium—complex [MAC] infection) in persons whose CD4+ T lymphocyte counts had increased by ⩾100 cells/µL to exceed the threshold of risk and in persons whose CD4+ counts had never dropped below the threshold of risk, we analyzed data collected during the period 1990–1998 in the Adult/Adolescent Spectrum of HIV (Human Immunodeficiency Virus) Disease Project. Using a counting-process formulation of the Cox model, we analyzed observation time in these 2 groups for persons who were prescribed antiretroviral therapy but not prophylaxis. The incidences of the infections were low for patients whose CD4+ count rose above the threshold of risk (PCP, 0.6 cases per 100 person-years [PY]; MAC, 1.0 cases per 100 PY) and not higher than in persons whose CD4+ counts had not decreased below these thresholds, which suggests that discontinuation of primary prophylaxis for opportunistic infections may be considered for some patients.
ISSN:0022-1899
1537-6613
DOI:10.1086/315734