PJP — SCE Infectious Diseases MCQ

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EasyHIV MedicinePJPSCE Infectious Diseases

A 38-year-old man with HIV has a CD4 count of 85 cells/µL and is Toxoplasma IgG positive. He is starting ART. What is the most appropriate prophylaxis?

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Correct answer: B — Co-trimoxazole 960 mg once daily

Co-trimoxazole 960 mg (double-strength) once daily is the preferred agent for both PJP and Toxoplasma prophylaxis. PJP prophylaxis is indicated at CD4 <200 cells/µL. Toxoplasma prophylaxis is additionally indicated in Toxoplasma IgG-positive patients with CD4 <200 cells/µL. Pentamidine nebuliser provides PJP prophylaxis only and has no activity against Toxoplasma. Dapsone alone is ineffective against Toxoplasma; pyrimethamine and leucovorin would need to be added.

Reference: BHIVA 2022 – Guidelines on the treatment of opportunistic infections in adults with HIV; US DHHS 2024 – OI Guidelines