Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count <200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial

Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count <200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial

The CDC recommends discontinuing opportunistic infections (OIs) prophylaxis in HIV-infected patients who have CD4+ cell count >200 cells/mm3 after receiving combination antiretroviral therapy (cART). A prospective randomized controlled trial was conducted at Chiang Mai University Hospital from Ju...

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Main Authors: Romanee Chaiwarith, Jutarat Praparattanapan, Nontakan Nuntachit, Wilai Kotarathitithum, Khuanchai Supparatpinyo
Format: Journal
Published: 2018
Subjects:
Medicine
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84873335200&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/52905
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-529052018-09-04T09:34:22Z Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial Romanee Chaiwarith Jutarat Praparattanapan Nontakan Nuntachit Wilai Kotarathitithum Khuanchai Supparatpinyo Medicine The CDC recommends discontinuing opportunistic infections (OIs) prophylaxis in HIV-infected patients who have CD4+ cell count >200 cells/mm3 after receiving combination antiretroviral therapy (cART). A prospective randomized controlled trial was conducted at Chiang Mai University Hospital from June 1, 2009 to January 31, 2012 in 74 adult HIV-infected patients who had received cART and had CD4+ cell count <200 cells/mm3 but plasma HIV-1 RNA<50 copies/ml. Forty-three patients (58.1%) were male and the mean age was 41.8±8.1 years; 68 (91.9%) and 59 (79.7%) patients were receiving co-trimoxazole and antifungal prophylaxis, respectively. The median CD4+ cell counts at enrollment were 142 (IQR 108, 161) and 158 (IQR 141, 176) cells/mm3 among patients who discontinued and continued OIs prophylaxis, respectively (p value=0.041). One of 37 patients (2.7%) in the discontinuation group developed Pneumocystis jiroveci pneumonia, giving the incidence rate of 1.57/1000 person-months. None of the 37 patients in the continuation group developed OIs. The difference in the prevention rates of OIs between groups was -2.7% (95% CI -7.9, 2.5). In conclusion, in the setting where plasma HIV-RNA measurement is available, e.g., Asia-Pacific region, discontinuation of prophylaxis is considerably safe in HIV-infected patients receiving cART with undetectable plasma HIV-RNA but incomplete immune recovery. © Copyright 2013, Mary Ann Liebert, Inc. 2013. 2018-09-04T09:34:22Z 2018-09-04T09:34:22Z 2013-02-01 Journal 15577449 10872914 2-s2.0-84873335200 10.1089/apc.2012.0303 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84873335200&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/52905
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Romanee Chaiwarith
Jutarat Praparattanapan
Nontakan Nuntachit
Wilai Kotarathitithum
Khuanchai Supparatpinyo
Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial
description The CDC recommends discontinuing opportunistic infections (OIs) prophylaxis in HIV-infected patients who have CD4+ cell count >200 cells/mm3 after receiving combination antiretroviral therapy (cART). A prospective randomized controlled trial was conducted at Chiang Mai University Hospital from June 1, 2009 to January 31, 2012 in 74 adult HIV-infected patients who had received cART and had CD4+ cell count <200 cells/mm3 but plasma HIV-1 RNA<50 copies/ml. Forty-three patients (58.1%) were male and the mean age was 41.8±8.1 years; 68 (91.9%) and 59 (79.7%) patients were receiving co-trimoxazole and antifungal prophylaxis, respectively. The median CD4+ cell counts at enrollment were 142 (IQR 108, 161) and 158 (IQR 141, 176) cells/mm3 among patients who discontinued and continued OIs prophylaxis, respectively (p value=0.041). One of 37 patients (2.7%) in the discontinuation group developed Pneumocystis jiroveci pneumonia, giving the incidence rate of 1.57/1000 person-months. None of the 37 patients in the continuation group developed OIs. The difference in the prevention rates of OIs between groups was -2.7% (95% CI -7.9, 2.5). In conclusion, in the setting where plasma HIV-RNA measurement is available, e.g., Asia-Pacific region, discontinuation of prophylaxis is considerably safe in HIV-infected patients receiving cART with undetectable plasma HIV-RNA but incomplete immune recovery. © Copyright 2013, Mary Ann Liebert, Inc. 2013.
format Journal
author Romanee Chaiwarith
Jutarat Praparattanapan
Nontakan Nuntachit
Wilai Kotarathitithum
Khuanchai Supparatpinyo
author_facet Romanee Chaiwarith
Jutarat Praparattanapan
Nontakan Nuntachit
Wilai Kotarathitithum
Khuanchai Supparatpinyo
author_sort Romanee Chaiwarith
title Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial
title_short Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial
title_full Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial
title_fullStr Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial
title_full_unstemmed Discontinuation of primary and secondary prophylaxis for opportunistic infections in HIV-Infected Patients Who Had CD4+ Cell Count &lt;200 cells/mm3 but Undetectable Plasma HIV-1 RNA: An Open-Label Randomized Controlled Trial
title_sort discontinuation of primary and secondary prophylaxis for opportunistic infections in hiv-infected patients who had cd4+ cell count &lt;200 cells/mm3 but undetectable plasma hiv-1 rna: an open-label randomized controlled trial
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84873335200&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/52905
_version_ 1681424036526030848

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