Discontinuing Prophylaxis against Recurrent Opportunistic Infections in HIV-Infected Persons: A Victory in the Era of HAART
Authors: Jonathan E. Kaplan, Henry Masur, King K. Holmes
Journal: Annals of Internal Medicine (2002)

Editorials20 August 2002Discontinuing Prophylaxis against Recurrent Opportunistic Infections in HIV-Infected Persons: A Victory in the Era of HAARTJonathan E. Kaplan, MD, Henry Masur, MD, and King K. Holmes, MD, PhDJonathan E. Kaplan, MDSearch for more papers by this author, Henry Masur, MDSearch for more papers by this author, and King K. Holmes, MD, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-4-200208200-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The use of highly active antiretroviral therapy (HAART) has resulted in a remarkable decrease in morbidity and mortality among HIV-infected persons. The immune reconstitution resulting from successful use of HAART has raised the possibility that chemoprophylaxis against specific opportunistic infections—therapy that heretofore was considered required for life—might safely be discontinued. While several observational and randomized studies have provided strong support for this practice against first episodes of Pneumocystis carinii pneumonia, disseminated Mycobacterium avium complex (MAC) disease, and toxoplasmic encephalitis (1-3), data on discontinuation of prophylaxis after an episode of disease—so called “secondary prophylaxis” or chronic maintenance therapy—are sparse, except those ...References1. Furrer H, Egger M, Opravil M, Bernasconi E, Hirschel B, Battegay M, et al . Discontinuation of primary prophylaxis against Pneumocystis carinii pneumonia in HIV-1-infected adults treated with combination antiretroviral therapy. Swiss HIV Cohort Study. N Engl J Med. 1999;340:1301-6. [PMID: 10219064] CrossrefMedlineGoogle Scholar2. 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Komanduri KV, Feinberg J, Hutchins RK, Frame RD, Schmidt DK, Viswanathan MN, et al . Loss of cytomegalovirus-specific CD4 T cell responses in human immunodeficiency virus type 1-infected patients with high CD4 T cell counts and recurrent retinitis. J Infect Dis. 2001;183:1285-9. [PMID: 11262214] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Corresponding Author: Jonathan E. Kaplan, MD, Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road, Atlanta, GA 30333.Current Author Addresses: Dr. Kaplan: Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road, Atlanta, GA 30333.Dr. Masur: National Institutes of Health, Department of Critical Care Medicine, Building 10, Room 7043, Bethesda, MD 20892.Dr. Holmes: University of Washington, Center for AIDS and STD, 1001 Broadway, Suite 215, Seattle, WA 98122. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSafe Interruption of Maintenance Therapy against Previous Infection with Four Common HIV-Associated Opportunistic Pathogens during Potent Antiretroviral Therapy Ole Kirk , Peter Reiss , Caterina Uberti-Foppa , Markus Bickel , Jan Gerstoft , Christian Pradier , Ferdinand W. Wit , Bruno Ledergerber , Jens D. 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