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Stopping PJP Toxoplasma Prophylaxis — SCE Infectious Diseases MCQ

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HardHIV MedicineStopping PJP Toxoplasma ProphylaxisSCE Infectious Diseases

A Toxoplasma-IgG-positive person with HIV receives co-trimoxazole prophylaxis for both Pneumocystis and toxoplasmosis. When can both indications normally be stopped?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — After CD4 remains above 200 cells/µL for at least 3 months on suppressive ART

The best answer is “After CD4 remains above 200 cells/µL for at least 3 months on suppressive ART”. Sustained immune recovery above 200 cells/µL on effective ART permits discontinuation of both prophylaxes, with re-initiation if immunosuppression recurs. BHIVA guidance governs investigation and treatment of HIV-associated disease and supports standard specialist care when HIV is virologically controlled.

Reference: BHIVA clinical guidelines: https://bhiva.org/clinical-guidelines/