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  • 1.  Prophylaxis Guidelines with HIV and Cancer management

    Posted 11-27-2022 08:24
    What are the guidelines regarding monitoring a PLWH who is virally suppressed for multiple years but their absolute CD4 dropped below 200 from the lymphocytopenia due the cancer, with the CD4 percentage way above 14.

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    Jeremy Aguinaldo
    Macon GA
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  • 2.  RE: Prophylaxis Guidelines with HIV and Cancer management

    Posted 02-01-2023 14:04
    Hi there,
    Late reply, but I was just browsing the discussions. I have some patients in this situation. I believe in the Oncology literature, if a patient is going to have prolonged CD4 suppression (due to chemo or their disease itself), irrespective of HIV status, they sometimes prescribe PJP and other fungal ppx. Therefore, I think if it's consistent with their goals of care, you could put the patient on PJP ppx - especially if they can take an easy regimen, like Bactrim - but you could check with the oncologist as well.

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    Julia Cooper MD, AAHIVS
    New York, NY
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    Original Message


  • 3.  RE: Prophylaxis Guidelines with HIV and Cancer management

    Posted 05-25-2023 21:22
    Edited by Debbie Nguyen 05-25-2023 21:22

    Hi Jeremy,

    The two guidelines in the U.S. for cancer treatment are the NCCN and ASCO guidelines. I found the NCCN oncology guidelines providing guidance depending on the type of cancer. For my HIV patients, newly diagnosed with cancer, I scan the NCCN guidelines, by pulling up that specific cancer and follow the flow chart/algorithm to view recommendations for OI prophylaxis and counsel them on food safety due to CD4 count drop putting them at risk of OI. 

    Below is a PDF link of such an example. I recommend creating an account on the NCCN network to view the latest guidelines as the link available publicly may not be the most recent.

    https://www.nccn.org/professionals/physician_gls/pdf/hiv.pdf



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    Debbie Nguyen, PharmD, AAHIVP
    Seattle, WA
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    Original Message