Stopping PJP prophylaxis in HIV - Trip Gulick, MD/ Michael Saag, MD

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IDBR Infectious Disease Board Review

John Bennett, MD / Henry Masur, MD

22 episodes

6 days ago

The Infectious Disease Board Review (IDBR) Course is designed to help physicians prepare for the American Board of Internal Medicine (ABIM) Infectious Disease certification/recertification exam. This comprehensive review features exam-focused lectures presented by the Nation’s leading infectious disease experts, case-based reviews, online practice exams featuring over 500 ABIM-style and photo-based questions, and additional study guides and primers. https://www.idbrcourse.org/

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Stopping PJP prophylaxis in HIV - Trip Gulick, MD/ Michael Saag, MD

IDBR Infectious Disease Board Review

3 minutes 29 seconds

1 year ago

Stopping PJP prophylaxis in HIV - Trip Gulick, MD/ Michael Saag, MD

A 44-year-old man was diagnosed with Pneumocystis pneumonia as his AIDS-defining illness and begun on antiretroviral therapy with 2 nucleosides and an integrase inhibitor during his hospitalization. He stabilizes and follows up for repeated outpatient visits with an HIV RNA consistently <20 copies/ml and a CD4 cell count of 44 that increased to 163 (at 3 months), 232 (at 6 months), 242 (at 9 months), and was repeated at 243 (at 12 months).

His current medications are: tenofovir alafenamide/emtricitabine, dolutegravir, trimethoprim-sulfa double strength daily, and azithromycin 1200 mg once weekly. He says he’s tired of taking pills and would like to stop some of them.

What do you recommend?

A. Stop tenofovir alafenamide/emtricitabine

B. Stop trimethoprim-sulfa

C. Stop azithromycin

D. Stop trimethoprim-sulfa and azithromycin

E. Continue the current regimen