IDSA Recommendations for Prevention and Treatment of Pneumocystis Pneumonia (PCP) in HIV-AIDS Indications for Initiating Primary Prophylaxis: • CD4 count <200 cells/mm3 or • CD4% <14% of total lymphocyte count or • CD4 count >200 but <250 cells/mm3, if ART cannot be initiated, and if CD4 cell count monitoring (e.g., every 3 months) is not possible Preferred Therapy: • TMP-SMX, 1 DS PO daily or • TMP-SMX, 1 SS PO daily Alternative Therapy: • TMP-SMX 1 DS PO three times weekly or • Dapsoneb,c 100 mg PO daily or 50 mg PO BID Indication for Discontinuing Primary Prophylaxis: • CD4 count increased from <200 cells/mm3 to ≥200 cells/mm3 for at least 3 months in response to ART • Can consider if CD4 count 100-200 cells/mm3 and HIV RNA remain below limit of detection for at least 3-6 months Indication for Restarting Primary Prophylaxis: • CD4 count <100 cells/mm3 regardless of HIV RNA • CD4 count 100-200 cells/mm3 and with HIV RNA above detection limit of the assay #Pneumocystis #Pneumonia #IDSA #Prevention #Treatment #PCP #PJP #jiroveci #opportunistic #infections #HIVAIDS #management #pharmacology
