Prevention: PCP and MAC Prophylaxis

Management of chronic HIV disease includes outpatient and inpatient services. Because national data on HIV care are not routinely collected, HIV measures tracked in NHQR come from the HIV Research Network, which consists of 18 medical practices across the United States that treat large numbers of HIV patients. Although program data are collected from all Ryan White CARE Act grantees, the aggregate nature of the data makes it difficult to assess the quality of care provided by Ryan White CARE Act providers. As HIV disease progresses, CD4 cell counts fall and patients become increasingly susceptible to opportunistic infections. When CD4 cell counts fall below 200, medicine to prevent development of Pneumocystis pneumonia (PCP) is routinely recommended; when CD4 cell counts fall below 50, medicine to prevent development of disseminated Mycobacterium avium complex (MAC) infection is routinely recommended.¹⁷

Figure 2.15. Percentage of eligible AIDS patients receiving PCP and MAC prophylaxis, 2002

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Source: HIV Research Network, 2002.

Note: Data from the HIV Research Network are not nationally representative of the level of care received by all Americans living with HIV. Participation in this network is voluntary, and network data only represent patients that are actually receiving care. Furthermore, data shown above are not representative of the HIV Research Network as a whole, because they represent only a subset of of network sites that have the best quality data. (For more information on the HIV Research Network, go to http://www.ahrq.gov/data/hivnet.htm.)

• Of those patients eligible (2,533 AIDS patients with at least two CD4 cell counts below 200), 90% received PCP prophylaxis (Figure 2.15), which is below the Healthy People 2010 target of 95%.
• Of those patients eligible (754 AIDS patients with at least two CD4 cell counts below 50), 88% received MAC prophylaxis, which is below the Healthy People 2010 target of 95%.

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