title: Prescription of Pneumocystis Jiroveci Pneumonia Prophylaxis in HIV-Infected Patients.
abstract: The US treatment guidelines recommend Pneumocystis jiroveci pneumonia (PCP) prophylaxis for all HIV-infected persons with a CD4 count <200 cells/mm3(ie, eligible for PCP prophylaxis). However, some studies suggest PCP prophylaxis may be unnecessary in virally suppressed patients. Using national data of HIV-infected adults receiving medical care in the United States during 2009 to 2012, the authors assessed the weighted percentage of eligible patients who were prescribed PCP prophylaxis and the independent association between PCP prophylaxis prescription and viral suppression. Overall, 81% of eligible patients were prescribed PCP prophylaxis. Virally suppressed eligible patients were less likely to be prescribed PCP prophylaxis (prevalence ratio: 0.84; 95% confidence interval: 0.80-0.89). Although guidelines recommend PCP prophylaxis for all eligible patients, some HIV care providers might not prescribe PCP prophylaxis to virally suppressed patients. Additional data on the risk for PCP among virally suppressed patients are needed to clarify this controversy.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA wft4@cdc.gov.|Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
authors.forename: Xia
authors.initials: X
authors.lastname: Lin
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
authors.forename: Shikha
authors.initials: S
authors.lastname: Garg
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Mattson
authors.affiliation: ICF International, Atlanta, GA, USA.
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Luo
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA, USA.
authors.forename: Jacek
authors.initials: J
authors.lastname: Skarbinski
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D018791:CD4 Lymphocyte Count; D005260:Female; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D017410:Practice Guidelines as Topic; D055815:Young Adult
keywords: HIV; Pneumocystis pneumonia prophylaxis; viral suppression