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You Can Prevent PCP in Children: A Guide for People With HIV Infection

June 21, 2007

  • PCP is the most serious infection among children with HIV. It can be fatal.
  • PCP can be prevented and treated.
  • TMP-SMX, also known as Bactrim, Septra, or Cotrim*, is the best medicine for preventing and treating PCP.
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  • Early diagnosis and treatment of HIV in pregnant women can help prevent HIV and PCP in their children.


What Is PCP?

Pneumocystis carinii (NEW-mo-SIS-tis CA-RIN- nee-eye) pneumonia, or "PCP," is a severe illness that adults and children with HIV or AIDS may get. It is caused by a germ called Pneumocystis carinii. Most children infected with this germ don't get pneumonia because their immune systems are normal. Children whose immune systems are badly damaged by HIV can get PCP. Children with HIV are less likely to get PCP today than in earlier years. However, PCP is still the most common serious infection among children with AIDS in the United States.

How Do I Know if My Child Has PCP?

If your child has PCP, he or she probably will have fever, cough, or trouble breathing. Children with PCP may die if the infection is not treated quickly. See your doctor immediately if your child has these symptoms. PCP can be diagnosed only by laboratory tests of fluid or tissue from the lungs.


How Could My Child Catch PCP?

Most scientists believe PCP is spread in the air, but they don't know if it lives in the soil or someplace else. The PCP germ is very common. Since it is difficult to prevent exposure to PCP, you should get medical care for your child to prevent PCP.


How Can I Prevent PCP in My Child?

The best way to prevent PCP in children is to prevent HIV in children. Pregnant women with HIV should speak with their doctors about taking antiretroviral treatments to prevent passing their HIV infection to their unborn child. Children whose mothers have HIV also can take anti-viral treatments and medicine to prevent PCP. The best drug for preventing PCP is trimethoprim-sulfamethoxazole (try-METH-o- prim - sul-fa-meth-OX-uh-sole), or TMP-SMX. What is TMP-SMX? TMP-SMX is a combination of two medicines. It has many different brand names, such as Bactrim, Septra, and Cotrim*. Older children can take TMP-SMX in tablet form. You can also get TMP-SMX as a liquid for babies and young children.


What Children Should Get Treatment to Prevent PCP?

All babies born to mothers with HIV should get TMP-SMX starting at 4 to 6 weeks old, even if it isn't known yet if they have HIV. This will help prevent PCP infection before it starts. If HIV tests later show that your baby does not have HIV, the TMP-SMX treatment can be stopped. If your baby has HIV, he or she should continue to get TMP-SMX treatment until reaching the age of 1 year. Your doctor will then decide if your child needs to continue the treatment, based on your baby's CD4 cell (sometimes called T cell) count.

Babies don't get TMP-SMX treatment until they are at least 4 weeks old because most children will be taking zidovudine (also called AZT), and small children shouldn't take the two drugs together. Also, TMP-SMX can cause liver damage in babies younger than 4 weeks old. Babies don't usually get PCP until they are at least 8 weeks old.

What Are the Side Effects of TMP-SMX?

TMP-SMX can make some people have a rash or feel sick. If the drug reaction is not severe, TMP-SMX should be continued because it works so much better than any other medicine to prevent PCP.


Are There Other Medicines to Prevent PCP?

Yes. Check with your doctor about the possibility of other treatments. Your child should take all of his or her medicines as prescribed by your doctor. Don't lower the dosage without speaking with your doctor.


Can My Child Get PCP More than Once?

Yes. If your child has already had PCP, he or she can get it again. TMP-SMX can prevent second infections with PCP. Therefore, treatment should be used even after your child has had PCP to prevent getting it again.


For More Information

Free referrals and information:

CDC-INFO
1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348
In English, en Español
24 Hours/Day

Free materials:

CDC National Prevention Information Network
(800) 458-5231
1-301-562-1098 (International)
P.O. Box 6003
Rockville, MD 20849-6003

Free HIV/AIDS treatment information:

AIDSinfo
(800) 448-0440

Project Inform
(800) 822-7422

Drugs undergoing clinical trials:

AIDSinfo
(800) 448-0440

Social Security benefits:

Social Security Administration
(800) 772-1213

(You also may request a personal earnings and benefit estimate statement to help you estimate the retirement, disability, and survivor benefits payable on your Social Security record.)

Child Health Insurance Program
1-877 KIDS NOW (1-877-543-7669)

CDC Division of HIV/AIDS Prevention Internet address: www.cdc.gov/hiv/

Additional brochures in the Opportunisitic Infections Series:

* Use of trade names does not imply endorsement by the United States Department of Health and Human Services.


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This article was provided by U.S. Centers for Disease Control and Prevention. Visit the CDC's website to find out more about their activities, publications and services.
 

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