Dapsone/Pyrimethamine May Prevent Mycobacterial Disease in Immunosuppressed Patients Infected with the Human Immunodeficiency Virus

Opravil, Milos; Pechère, Marc; Lazzarin, Adriano; Heald, Alison; Rüttimann, Sigmund; Iten, Anne; Furrer, Hansjakob; Oertle, Daniel; Praz, Gerard; Vuitton, Dominique A.; Hirschel, Bernard; Lüthy, Ruedi (1995). Dapsone/Pyrimethamine May Prevent Mycobacterial Disease in Immunosuppressed Patients Infected with the Human Immunodeficiency Virus. Clinical infectious diseases, 20(2), pp. 244-249. The University of Chicago Press 10.1093/clinids/20.2.244

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Dapsone exhibits activity against Mycobacterium tuberculosis and Mycobacterium avium complex (MAC) in vitro. We retrospectively examined the incidence of mycobacterial diseases within a randomized prospective trial of prophylaxis for Pneumocystis carinii pneumonia and toxoplasmosis. Of 501 participants who had not previously had a mycobacterial disease, 274 received dapsone/pyrimethamine (200/75 mg once weekly) and 227 received aerosolized pentamidine (300 mg once every 4 weeks). The median CD4 lymphocyte count was 113/µL, and the median duration of treatment was 369 days. Six cases of tuberculosis, 22 of MAC infection, and 3 of Mycobacterium genavense disease occurred during treatment. Stratified by baseline CD4 lymphocyte counts, the annual product-limit incidence of mycobacterial disease was 5% during treatment with dapsone/pyrimethamine vs. 12% during treatment with aerosolized pentamidine for patients whose counts were 0–24/µL, 0 vs. 12% for those whose counts were 25–49/µL, and 7% vs. 9% for those whose counts were 50–99/µL. Adjusted for CD4 lymphocyte counts at start of treatment, the relative risk for patients receiving dapsone/pyrimethamine was 0.47 (95% confidence interval, 0.19–1.16; P = .10). This inexpensive and simple regimen may prevent mycobacterial diseases and warrants further investigation as a means of prophylaxis for multiple opportunistic diseases.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Furrer, Hansjakob


600 Technology > 610 Medicine & health




The University of Chicago Press




Marceline Brodmann

Date Deposited:

17 Nov 2020 08:49

Last Modified:

05 Dec 2022 15:13

Publisher DOI:






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