Open AccessIncidence and Determinants of Bacterial Infections in HIV-Positive Patients Receiving Anti-Pneumocystis carinii/ Toxoplasma gondii Primary Prophylaxis Within a Randomized Clinical Trial
Author(s) -
Rita Murri,
Adriana Ammassari,
Patrizio Pezzotti,
Antonella Cingolani,
Andrea De Luca,
Federica Pallavicini,
R Grillo,
Andrea Antinori
Publication year - 2001
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/00126334-200105010-00009
Subject(s) - pneumocystis carinii , toxoplasma gondii , incidence (geometry) , secondary prophylaxis , toxoplasmosis , medicine , immunology , human immunodeficiency virus (hiv) , aids related opportunistic infections , randomized controlled trial , virology , clinical trial , sida , antibody , viral disease , pneumocystis jirovecii , physics , optics
We assessed the incidence and determinants of bacteremia, pneumonia, and sinusitis/otitis in HIV-positive people receiving cotrimoxazole (CTX) or dapsone-pyrimethamine (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 of bacteremia, pneumonia, and sinusitis/otitis as well as the 2-year probability of remaining free from any bacterial infection were not significantly different between the two groups. At multivariate analysis, the risks of developing bacteremia and pneumonia were found to be independently increased by the use of a central venous catheter (hazard ratio [HR], 4.48; p <.05 and HR, 4.13; p <.01, respectively) and by hospitalization (HR, 28.82; p <.05 and HR, 10.15; p <.05, respectively). In conclusion, CTX at the dosage employed for primary PCP/TE prophylaxis does not seem to protect against bacterial infections more than second-line DP.