inPractice® - Primary Prophylaxis

Guidelines on opportunistic infections recommend that prophylaxis should be prescribed for all Toxoplasma-seropositive HIV-infected patients with CD4+ cell counts < 100 cells/mm³ (Table 4) (Management Guidelines)^{[CDC OI]} (Management Guidelines)^{[Panel 2008a]}
Recommended regimen for primary prophylaxis is sulfamethoxazole/trimethoprim 800/160 mg once daily, or the same dose taken 3 times weekly
Primary prophylaxis for toxoplasmosis can be discontinued in patients taking effective antiretroviral therapy for > 6 months if the CD4+ cell count increases to > 200 cells/mm³ for ≥ 3 months (Table 5)^{[CDC OI; Panel 2008a; Miro 2006; Lejeune 2011]}