OPPORTUNISTIC INFECTIONS PCP

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OPPORTUNISTIC INFECTIONS PCP

AIDS Treatment Update, No. 44, August 1996
Edward King

Two studies examined why people are still developing PCP as their first AIDS-defining illness even though highly effective prophylactic drugs such as co-trimoxazole (Septrin) are available. Both the Swiss and the American researchers concluded that these cases almost exclusively occur in people who are not receiving prophylaxis (Tu.B.113, Tu.B.114).

Several studies presented ways in which people who suffer allergic reactions to Septrin can be desensitised, enabling many to take the drug without further problems. In one study, Septrin was started at a very low dose and gradually increased, alongside a gradually reducing dose of steroids to minimise the allergy, enabling nearly four out of five previously allergic people to tolerate Septrin (Tu.B.414). However, the design of this study means that this is a best-case estimate of the effectiveness of desensitisation.

An American study found that among people who are taking PCP prophylaxis, the risk of developing PCP was reduced even further if they were also receiving the drug azithromycin to prevent MAI, rather than the alternative MAI prophylactic drug rifabutin (Tu.B.410). In the USA, azithromycin was licensed for MAI prophylaxis in June (see AIDS Treatment Update issue 43).


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