A community-based study of the incidence of trimethoprim-sulfamethoxazole-preventable infections in Malawian adults living with HIV.

Journal Article

The benefits of trimethoprim-sulfamethoxazole (TS) prophylaxis reported for persons living with HIV in Cote d'Ivoire are difficult to extrapolate to sub-Saharan African countries where bacterial resistance to TS is higher and cross-resistance between TS and sulfadoxine-pyrimethamine (SP) may impair SP efficacy for malaria treatment. We conducted a community-based cohort study to measure the incidence of potentially TS-preventable illnesses in Blantyre, Malawi. We found a high incidence of malaria, invasive bacterial infections, and probable bacterial pneumonias but low rates of Pneumocystis jiroveci pneumonia, isosporiasis, and Toxoplasma encephalitis. Most bacterial isolates were resistant to TS but sensitive to azithromycin, a possible alternative to TS. Clinical trials are needed to determine the role of TS or alternative regimens for prophylaxis against secondary infections among people living with HIV in sub-Saharan Africa. These should also assess benefit in patients receiving antiretroviral therapy.

Duke Authors

Cited Authors

  • van Oosterhout, JJG; Laufer, MK; Graham, SM; Thumba, F; Perez, MA; Chimbiya, N; Wilson, L; Chagomerana, M; Molyneux, ME; Zijlstra, EE; Taylor, TE; Plowe, CV

Published Date

  • August 2005

Published In

Volume / Issue

  • 39 / 5

Start / End Page

  • 626 - 631

PubMed ID

  • 16044018

Electronic International Standard Serial Number (EISSN)

  • 1944-7884

International Standard Serial Number (ISSN)

  • 1525-4135

Language

  • eng