{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:04:50Z","timestamp":1777421090120,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2015,9,10]],"date-time":"2015-09-10T00:00:00Z","timestamp":1441843200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:p>\n                    Objective: To review the evidence for discontinuing primary and secondary Pneumocystis jirovecii pneumonia (PJP) prophylaxis in HIV-infected patients with a CD4 count &lt;200 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    . Data Sources: We conducted a literature search in MEDLINE, EMBASE, Cochrane Library, Google Scholar, and the International Aids Society Library (up to August 2015) using the following key search terms: Pneumocystis jirovecii, pneumonia, human immunodeficiency virus, primary prophylaxis, secondary prophylaxis, and discontinuation. Study Selection and Data Extraction: All English-language studies that evaluated discontinuation of primary and\/or secondary PJP prophylaxis in HIV-infected patients with CD4 count &lt;200 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    were included. Data Synthesis: Five studies were identified, which varied in design, sample size, outcomes, and duration of follow-up. Three studies examined discontinuation of primary and secondary PJP prophylaxis; 1 study evaluated discontinuing primary PJP prophylaxis; and 1 study evaluated stopping secondary PJP prophylaxis. Two out of the 5 studies pooled data for all opportunistic infections. Overall, there was a low incidence of PJP among HIV-infected patients who discontinued primary PJP prophylaxis and were well controlled on antiretroviral therapy (ART). Conclusions: Discontinuation of primary PJP prophylaxis appears to be safe in patients on combination ART with a suppressed HIV viral load and a CD4 count &gt;100 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    . Additional data are needed to support the safety of discontinuing secondary PJP prophylaxis. Decisions to discontinue PJP prophylaxis in patients with a CD4 count &lt;200 cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    should be done on an individual patient basis, taking into consideration clinical factors, including ongoing adherence to ART.\n                  <\/jats:p>","DOI":"10.1177\/1060028015605113","type":"journal-article","created":{"date-parts":[[2015,9,10]],"date-time":"2015-09-10T22:28:54Z","timestamp":1441924134000},"page":"1343-1348","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Discontinuing\n                    <i>Pneumocystis jirovecii<\/i>\n                    Pneumonia Prophylaxis in HIV-Infected Patients With a CD4 Cell Count &lt;200 cells\/mm\n                    <sup>3<\/sup>"],"prefix":"10.1177","volume":"49","author":[{"given":"Vaninder K.","family":"Sidhu","sequence":"first","affiliation":[{"name":"Alberta Health Services, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Foisy","sequence":"additional","affiliation":[{"name":"Royal Alexandra Hospital, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine A.","family":"Hughes","sequence":"additional","affiliation":[{"name":"University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,9,10]]},"reference":[{"key":"bibr1-1060028015605113","unstructured":"Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. http:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/adult_oi.pdf. Accessed June 23, 2015."},{"key":"bibr2-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2011.00944.x"},{"key":"bibr3-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028570"},{"key":"bibr4-1060028015605113","unstructured":"European AIDS Clinical Society Guidelines November 2014. http:\/\/www.eacsociety.org\/files\/guidelines-7.1-english.pdf. Accessed June 23, 2015."},{"key":"bibr5-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1086\/510746"},{"key":"bibr6-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32833e6d14"},{"key":"bibr7-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32826fb6fc"},{"key":"bibr8-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-126"},{"key":"bibr9-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2012.0303"},{"key":"bibr10-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200003100-00011"},{"key":"bibr11-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1086\/655761"},{"key":"bibr12-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199001183220304"},{"key":"bibr13-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200109280-00012"},{"key":"bibr14-1060028015605113","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199906180-00006"},{"key":"bibr15-1060028015605113","unstructured":"Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents. http:\/\/www.aidsinfo.nih.gov\/guidelines\/html\/1\/adult-and-adolescent-arv-guidelines\/0\/. Accessed June 23, 2015."}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1060028015605113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1060028015605113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1060028015605113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:16:00Z","timestamp":1777374960000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1060028015605113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,9,10]]},"references-count":15,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1177\/1060028015605113"],"URL":"https:\/\/doi.org\/10.1177\/1060028015605113","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,9,10]]}}}