title: Efficacy of primary chemoprophylaxis against Pneumocystis carinii pneumonia during the first year of life in infants infected with human immunodeficiency virus type 1.
abstract: To evaluate the efficacy of primary chemoprophylaxis in preventing Pneumocystis carinii pneumonia (PCP) in infants with perinatal human immunodeficiency virus-1 infection during the first year of life, we conducted a retrospective chart review of infants with human immunodeficiency virus-1 infection born at New York University Medical Center-Bellevue Hospital Center, in New York. Between March 1989 and March 1993, 24 infants received primary chemoprophylaxis with trimethoprim-sulfamethoxazole in the first year of life and 24 infants did not receive primary prophylaxis. The CD4+ T-lymphocyte counts in the two groups did not differ during the first year of life. The median age at the time of initiation of prophylaxis was 3 months, and the average duration of prophylaxis was 5.5 months. Among the infants who had not received prophylaxis, five cases of PCP were diagnosed at a median age of 5 months; in contrast, no cases of PCP were observed in the infants receiving prophylaxis (log-rank test, p = 0.017). The probability of surviving after 1 year of age was 92% for the children who received prophylaxis and 74% for those who did not (log-rank test, p = 0.035). These data indicate that chemoprophylaxis is highly effective in preventing primary PCP and improving survival time in infants with human immunodeficiency virus-1 infection.
authors.affiliation: Department of Pediatrics and Environmental Medicine, New York University Medical Center, NY 10016.
authors.forename: M
authors.initials: M
authors.lastname: Rigaud
authors.forename: H
authors.initials: H
authors.lastname: Pollack
authors.forename: E
authors.initials: E
authors.lastname: Leibovitz
authors.forename: M
authors.initials: M
authors.lastname: Kim
authors.forename: D
authors.initials: D
authors.lastname: Persaud
authors.forename: A
authors.initials: A
authors.lastname: Kaul
authors.forename: R
authors.initials: R
authors.lastname: Lawrence
authors.forename: D D
authors.initials: DD
authors.lastname: John
authors.forename: W
authors.initials: W
authors.lastname: Borkowsky
authors.forename: K
authors.initials: K
authors.lastname: Krasinski
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000517:prevention & control*; D000367:Age Factors; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000151:congenital*; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007958:Leukocyte Count; D008297:Male; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy / Q000517:prevention & control*; D011336:Probability; D012189:Retrospective Studies; D015996:Survival Rate; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination