Incidence and Determinants of Bacterial Infections in HIV‐Positive Patients Receiving Anti‐Pneumocystis carinii/Toxoplasma gondii Primary Prophylaxis Within a Randomized Clinical Trial

  title={Incidence and Determinants of Bacterial Infections in HIV‐Positive Patients Receiving Anti‐Pneumocystis carinii/Toxoplasma gondii Primary Prophylaxis Within a Randomized Clinical Trial},
  author={Rita Murri and A Ammassari and Patrizio Pezzotti and Antonella Cingolani and Andrea De Luca and Federico Pallavicini and Rita Luciana Grillo and Armando Antinori},
  journal={JAIDS Journal of Acquired Immune Deficiency Syndromes},
Summary: We assessed the incidence and determinants of bacteremia, pneumonia, and sinusitis/otitis in HIV‐positive people receiving cotrimoxazole (CTX) or dapsonepyrimethamine (DP) for primary prophylaxis of Pneumocystis carinii pneumonia (PCP) and toxoplasmic encephalitis (TE) within a randomized clinical trial. In total, 244 patients were randomized: 122 were assigned to CTX and 122 to DP. In the cohort, 22 bacteremia, 63 pneumonia, and 39 sinusitis/otitis cases were observed. Incidence rates… 
Bacterial Infections in Adult HIV-Infected Patients
It is suggested that bacterial infections may have declined in the HAART era, as multicenter cohort studies have shown to be the case with AIDS-associated OIs, and preventive measures such as pneumococcal vaccination and smoking cessation remain effective strategies.
First Case of Toxoplasmosis Following Small Bowel Transplantation and Systematic Review of Tissue-Invasive Toxoplasmosis Following Noncardiac Solid Organ Transplantation
The findings support a reconsideration of pretransplantation evaluation and prophylaxis strategies in SOT recipients and Toxoplasmosis is recognized following noncardiac SOT.
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An increase of donors emigrated from tropical areas and more posttransplant patients traveling to endemic areas have led to a rise in parasitic infections reported among SOT recipients.
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PCP prophylaxis with TMP‐SMX apparently protects against communityacquired bacteremia in HIV‐infected persons.
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Results suggest that both P. carinii pneumonia and bacterial pneumonia are associated with a significantly worse subsequent HIV disease course and the proportion of cases occurring in association with a CD4 lymphocyte count of >200 suggest that measures to prevent bacterial pneumonia should be emphasized.
Drug smoking, Pneumocystis carinii pneumonia, and immunosuppression increase risk of bacterial pneumonia in human immunodeficiency virus-seropositive injection drug users.
Smoking illicit drugs had the strongest effect on risk of bacterial pneumonia among HIV-seropositive IDUs with a previous history of PCP, and age between 30 and 40 yr and smoking illicit drugs (marijuana, cocaine, or crack) were associated with bacterial pneumonia.
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The prolonged half-life of dapsone and the results of in vitro and in vivo studies suggest a potential efficacy for intermittent daps one-pyrimethamine regimens in the prophylaxis of P. carinii pneumonia and toxoplasmosis in patients infected with HIV who were at risk for these other infections.
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