Poh Lian LimJialun ZhouRossana A. DitangcoMatthew G. LawThira SirisanthanaNagalingeswaran KumarasamyYi Ming A. ChenPraphan PhanuphakChristopher Kc LeeVonthanak SaphonnShinichi OkaFujie ZhangJun Y. ChoiSanjay PujariAdeeba KamarulzamanPatrick Ck LiTuti P. MeratiEvy YunihastutiLiesl MesserschmidtSomnuek SungkanuparphTan Tock Seng HospitalUniversity of New South Wales (UNSW) AustraliaGokilaChiang Mai UniversityYR Gaitonde Centre for AIDS Research and EducationNational Yang-Ming University TaiwanThe HIV Netherlands Australia Thailand Research CollaborationHospital Sungai BulohNational Center for HIV/AIDSNational Center for Global Health and MedicineBeijing Ditan HospitalYonsei University College of MedicineInstitute of Infectious DiseasesUniversity of Malaya Medical CentreQueen Elizabeth Hospital Hong KongUniversitas UdayanaUniversity of Indonesia, RSUPN Dr. Cipto MangunkusumoTREAT Asia/amfAR-The Foundation for AIDS ResearchMahidol University2018-06-112018-06-112012-01-27Journal of the International AIDS Society. Vol.15, No.1 (2012)175826522-s2.0-84862780931https://repository.li.mahidol.ac.th/handle/20.500.14594/15011Background: Pneumocystis jiroveci pneumonia (PCP) prophylaxis is recommended for patients with CD4 counts of less than 200 cells/mm 3 . This study examines the proportion of patients in the TREAT Asia HIV Observational Database (TAHOD) receiving PCP prophylaxis, and its effect on PCP and mortality. Methods. TAHOD patients with prospective follow up had data extracted for prophylaxis using co-trimoxazole, dapsone or pentamidine. The proportion of patients on prophylaxis was calculated for each calendar year since 2003 among patients with CD4 counts of less than 200 cells/mm 3 . The effect of prophylaxis on PCP and survival were assessed using random-effect Poisson regression models. Results: There were a total of 4050 patients on prospective follow up, and 90% of them were receiving combination antiretroviral therapy. Of those with CD4 counts of less than 200 cells/mm 3 , 58% to 72% in any given year received PCP prophylaxis, predominantly co-trimoxazole. During follow up, 62 patients developed PCP (0.5 per 100 person-years) and 169 died from all causes (1.36/100 person-years). After stratifying by site and adjusting for age, CD4 count, CDC stage and antiretroviral treatment, those without prophylaxis had no higher risk of PCP, but had a significantly higher risk of death (incident rate ratio 10.8, p < 0.001). PCP prophylaxis had greatest absolute benefit in patients with CD4 counts of less than 50 cells/mm 3 , lowering mortality rates from 33.5 to 6.3 per 100 person-years. Conclusions: Approximately two-thirds of TAHOD patients with CD4 counts of less than 200 cells/mm 3 received PCP prophylaxis. Patients without prophylaxis had significantly higher mortality, even in the era of combination ART. Although PCP may be under-diagnosed, these data suggest that prophylaxis is associated with important survival benefits. © 2012 Lim et al; licensee BioMed Central Ltd.Mahidol UniversityMedicineArticleSCOPUS10.1186/1758-2652-15-1