Prophylaxis for Human Immunodeficiency Virus–Related Pneumocystis carinii Pneumonia

Abstract
PNEUMOCYSTIS CARINII pneumonia (PCP) is the most common serious opportunistic infection among patients infected with human immunodeficiency virus (HIV) in the United States.1-3 Initiating PCP prophylaxis at a CD4 cell count less than 200/µL has been the standard of care for the past decade.4,5 In the past few years, however, there has been a dramatic reduction in the rates of opportunistic infections in HIV-infected patients receiving highly active antiretroviral therapy (HAART), prompting reassessment of the role of prophylaxis.6-24 Several recent publications25-28 suggest a convergence of opinion in favor of discontinuing PCP prophylaxis in patients whose CD4 cell counts have increased to greater than 200/µL with HAART.

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