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Safe point for stopping prophylaxis
Feb 20, 2002

Since 1998 when first diagnosed I've been taking Diflucan (post cryptococcal meningitis) and Bactrim - my CD4s have slowly increased from 48 to 312 (13) just last month. My doctor said I may be able to stop the Diflucan and Bactrim if my count stays over 300 next month, and if my cryptococcal antigen is negative. Is this reasonable, or should I be more cautious, and if so, at what point would it generally be considered safe to stop the prophylaxys? The virus continues to be undetectable. Thank you.

Response from Dr. Feinberg

Your doctor is suggesting a reasonable approach. Stduies have shown that if the CD4 cells rise above 200 and stay there for at least 3-6 months, that further prophylaxis isi probably unnecessary. You may want to wait at least 3 months with your CD4 cells above 200 before stopping.

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