Incidence of Pneumocystis carinii pneumonia (PCP) in treatment-naïve HIV-infected adult patients receiving primary PCP chemoprophylaxis with 48-week antiretroviral initiation:(TJPS-2020-0271.R2)

Abstract

Objective: To determine the incidence of primary PCP between patients who received and did not receive primary PCP chemoprophylaxis and investigate adverse drug reactions (ADRs) related to the chemoprophylaxis use. 
Method: A retrospective study was conducted in Siriraj Hospital, Thailand. Data were collected from HIV-infected adults, initiated with Highly Active Antiretroviral Therapy (HAART) with initial CD4⁺< 200 cells/mm³. 
Results: Overall, 217 patients had a median initial CD4⁺of 83 cells/mm³ (IQR: 33.5 – 150.5) (range: 0 - 199), most of the initial HAART regimen was NNRTIs-based containing TDF (94.94%), and 104 patients (47.93%) received chemoprophylaxis. The incidence between patients who received and did not receive prophylaxis found no statistically significant difference (P = 0.133). Only one event was found in a severely immunocompromised patient who did not receive the prophylaxis. The absolute risk reduction of primary PCP incidence, and rate of ADRs was 0.89% (95% CI, -0.84, 2.61) and 10.58% in patients who received the chemoprophylaxis, respectively. 
Conclusion: The initiation of HAART in HIV-infected patients who had the initial CD4⁺cell count < 200 cells/mm³ may impact on reducing the risk of developing primary PCP. Aside from the patients who received the prophylaxis, most of the adverse reactions were skin disorders.