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Evidence summaries

Cotrimoxazole Prophylaxis for Opportunistic Infections in Adults with HIV

Cotrimoxazole is effective in reducing mortality and preventing illness in patients with HIV infection in Africa. Level of evidence: "A"

A Cochrane review (abstract , review [Abstract]) included 4 studies with a total of 1476 patients. Three trials (1416 people) studied heterosexual men and women in West Africa. A fourth trial was of homosexual men on chemotherapy for Kaposi's sarcoma, in the United States. Meta-analysis of the three African trials showed a significant beneficial effect of cotrimoxazole for death: relative risk 0.69 (95% confidence interval 0.55 to 0.87); for morbid events: 0.76 (0.64 to 0.9); and for hospitalisation: 0.66 (0.48 to 0.92). There was no significantly greater risk of adverse effects: relative risk 1.28 (0.47 to 3.51). Effects were similar in people with early and advanced HIV disease. Insufficient evidence was found on effects in areas with higher bacterial resistance or in people on antiretroviral therapy.

    References

    • Grimwade K, Swingler, G. Cotrimoxazole prophylaxis for opportunistic infections in adults with HIV. Cochrane Database Syst Rev 2003;(3):CD003108. [PubMed]

Primary/Secondary Keywords