Effects of Discontinuing PCP Prophylaxis in Patients with CD4 Counts > 200 Cells/mm3 on Antiretroviral Therapies

This study focuses on people living with HIV who are on antiretroviral therapies and have experienced an increase in their CD4 count to over 200 cells/mm3. The main goal is to understand if these individuals still need to continue with a specific preventive treatment, known as PCP prophylaxis, which helps protect against a type of pneumonia called Pneumocystis pneumonia (PCP). The importance of this study lies in determining whether it's safe to stop PCP prophylaxis once the immune system has improved, potentially simplifying treatment plans and reducing unnecessary medication use. Participants in this study will discontinue their PCP prophylaxis if their antiretroviral therapy has led to a sustained increase in their CD4 count above 200 cells/mm3, as confirmed by two measurements taken at least 12 weeks apart. They will then be regularly checked for symptoms and CD4 counts every 8 weeks, and their blood will be tested for HIV-RNA every 16 weeks for a period of 18 months. If a participant's CD4 count drops below certain levels, their CD4 count will be re-evaluated and, if still low, they will resume PCP prophylaxis and continue to be monitored as part of the study. Regular physical exams and laboratory tests will also be conducted at specific intervals to track participants' health.