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PCP Prophylaxis
Dec 14, 1999

My husband has been on Nelfinavir, d4T, and Efavirenz since May and his T4 count has risen to 374 and viral load <400. In your opinion, does he still need to be on Dapsone 100mg three days a week? We also plan to ask his doctor.

Response from Dr. Feinberg

There is good evidence that people with good control of their viral load and an increase in T4 cells above 200 for at least 3 months can safely discontinue their PCP prophylaxis. If your husband's T4 cells fall or his viral load becomes detectable, the situation is a bit less clear, but it would be prudent to restart dapsone if his T4 cells drop below 200 at some point in the future.


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