Adherence to PCP Prophylaxis Guidelines in HIV Positive Patients
 
 
Abstract:  
 
Introduction: Pneumocystis Pneumonia (PCP) prophylaxis is often continued despite acceptable CD4 counts in HIV positive individuals on antiretroviral (ARV) treatment.  Both BHIVA and EACS guidelines advise discontinuing prophylaxis if the CD4 count is >200 cells/mm3 for 3 months, EACS additionally states that prophylaxis should be stopped if the patient has a CD4 count of 100-200 and an undetectable Viral Load (VL) for 3 months.
 
Methods: We analysed the case notes of all individuals actively receiving Co-trimoxazole prophylaxis prescriptions, and assessed clinical details, CD4 count and VL data to decide whether their continued prescription was in accordance with current guidelines
 
Results: We identified 32 patients, 27 male, currently on Co-trimoxazole prophylaxis. 18 individuals (56%) met the criteria for continuing PCP prophylaxis.  Of the remaining 14, 3 individuals were on immunosuppressive medications for co-morbidities and were therefore appropriately receiving prophylaxis.  11 of 32 individuals (34%) were found to be receiving Co-trimoxazole despite meeting guidance for discontinuing prophylaxis. 8 of these patients met the BHIVA guidelines, whilst an additional 3 met the EACS guidelines.  
 
Discussion: Our results suggest a number of individuals currently receiving PCP prophylaxis could reduce pill burden and minimise the effects of polypharmacy, as well as reduce the cost to the NHS. Clinicians should therefore regularly review the need to continue PCP prophylaxis.

Adherence to PCP Prophylaxis Guidelines in HIV Positive Patients

The Joint Annual Conference of the British Association for Sexual Health and HIV & the Society for the Study of Sexually Transmitted Diseases in Ireland