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Partner newly diagnosed with HIV and PCP

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Ptrk3:
Not to worry, CD4 blips occur and a CD4 number can change 100 points or so daily.
What's important is that your partner continue to adhere to his antiretroviral regimen and remain undetectable.

As to your question, recent protocols suggest that primary and secondary PCP prophylaxis can be withdrawn as long as the patient has been undetectable for a lengthy period (three to six months) and maintains CD4's above 100 (and at 14% or thereabout), so your partner's doctor is not off the mark. 

https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-opportunistic-infection/321/pcp

Relevant language:

A combined analysis of 12 European cohorts16 and a case series66 found a low incidence of PCP in patients with CD4 counts between 100 and 200 cells/mm3, who were receiving ART and had HIV plasma viral loads <50 to 400 copies/mL, and who had stopped or never received PCP prophylaxis, suggesting that primary and secondary PCP prophylaxis can be safely discontinued in patients with CD4 counts between 100 to 200 cells/mm3 and HIV plasma RNA levels below limits of detection with commercial assays. Data on which to base specific recommendations are inadequate, but one approach would be to stop primary prophylaxis in patients with CD4 counts of 100 to 200 cells/mm3 if HIV plasma RNA levels remain below limits of detection for at least 3 to 6 months (BII). Similar observations have been made with regard to stopping primary prophylaxis for Toxoplasma encephalitis.67

Tonny2:


       ojo       hello dear lee...i wouldn't worry, your doctor is right, no need for septrim, he is UD, besides, if his % is raising, that means good news...i haven't read ptk reply, just if i sounded just like him...you two keep enkiying each other, he is doing great...best of luck and hugs                                                                           ojo

CaveyUK:
Indeed, a fairly stable setting such as UD and being adherent to meds, is one of those occasions where CD4% comes into play as it gives the doctor a better idea of whether there is a worrying trend going on or not.

It doesn't sound like there is a worrying trend in this case. So try to relax. You can never control CD4's and they can be impacted by just about anything including, as has been said, the time of day.

Lee82:
Hi all, just a quick update before the year end.

My partner continues to improve, his viral load remains undetectable and his cd4 count is around the 200 mark. Itís been 2 years since he nearly died so anyone reading this who is diagnosed late with single digit cd4 levels and PCP, recovery is possible.

Hope you all have a great Christmas and all the best for 2019!

Jim Allen:
Hiya

I'm sure people appreciate the update and, i'm glad to hear things are continuing to go well for your partner as he recovers.

Wishing you both all the best.

Jim

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