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Updated: Feb 13, 2026

Characterization of Inflammatory Responses During Intranasal Colonization with Streptococcus pneumoniae
Published on: January 17, 2014
Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and
Gildas Baulier1, Nahema Issa2, Frederic Gabriel3
1Department of Clinical Immunology,Saint-André Hospital, CHU de Bordeaux, France. gildas.baulier@chu-bordeaux.fr.
Objectives:
Guidelines for preventing Pneumocystis pneumonia (PCP) in HIV patients are based on CD4 below 200/mm3. Such cut-off value is suggested to guide prophylaxis in non-HIV conditions (NHIV) especially in autoimmune and inflammatory diseases (AD). We aimed to determine if CD4 could be used to guide PCP prophylaxis in AD.
Methods:
CD4 and lymphocyte-count were retrospectively studied in patients diagnosed with PCP between January 2013 and February 2016.
Results:
129 patients were included. The median CD4-count was 302/mm3 in AD, which was significantly higher than in HIV patients (19/mm3; p<0.0001). Fifty percent (n=10) of AD patients had CD4 counts greater than 300/mm3.
Conclusions:
Prophylaxis for PCP cannot rely solely on CD4-count in NHIV patients especially in AD.
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