At what CD4 count should Pneumocystis jiroveci pneumonia prophylaxis be initiated in HIV-positive patients?

Pneumocystis jiroveci pneumonia (PJP) is a significant opportunistic infection in individuals with HIV, particularly when their CD4 cell count falls below a certain threshold. The guidelines recommend initiating prophylaxis for PJP when the CD4 count drops to 200 cells/mm³ or lower. This is because at this level of immunosuppression, the risk of developing PJP significantly increases.

Prophylaxis with medications such as trimethoprim-sulfamethoxazole (TMP-SMX) can effectively reduce the incidence of PJP in at-risk patients. Regular monitoring of CD4 counts is essential for managing patients with HIV and ensuring that they receive appropriate preventive measures to avoid serious infections as their immune function declines. Preventative strategies are a critical aspect of HIV care to improve patient outcomes and quality of life.