Pneumocystis jiroveci pneumonia prophylaxis in HIV patients is indicated when CD4 count falls below what threshold?

Pneumocystis jiroveci pneumonia prophylaxis in HIV patients is indicated when CD4 count falls below what threshold?

• A. 200 cells/mm3
• B. 350 cells/mm3
• C. 500 cells/mm3
• D. 100 cells/mm3

Answer: (A)

Prophylaxis against Pneumocystis jirovecii pneumonia is indicated when the CD4 count drops below 200 cells per cubic millimeter. This level marks a sharp increase in risk for PCP as immune function declines, making preventive therapy important. The standard preventive treatment is trimethoprim-sulfamethoxazole, which greatly reduces PCP incidence; alternatives exist for those with sulfa allergies. Prophylaxis is typically continued until the CD4 count rises above 200 cells/mm3 for several months on effective antiretroviral therapy, at which point it can sometimes be stopped. Using a higher threshold would miss at-risk patients, while a lower threshold would delay needed protection.

Prophylaxis against Pneumocystis jirovecii pneumonia is indicated when the CD4 count drops below 200 cells per cubic millimeter. This level marks a sharp increase in risk for PCP as immune function declines, making preventive therapy important. The standard preventive treatment is trimethoprim-sulfamethoxazole, which greatly reduces PCP incidence; alternatives exist for those with sulfa allergies. Prophylaxis is typically continued until the CD4 count rises above 200 cells/mm3 for several months on effective antiretroviral therapy, at which point it can sometimes be stopped. Using a higher threshold would miss at-risk patients, while a lower threshold would delay needed protection.