Cotrimoxazole prophylaxis for infants exposed to HIV infection

Bulletin of the World Health Organization, April, 2004 by Stephen M. Graham

Uncertainty remains about the risks and benefits of implementing guidelines on the use of cotrimoxazole prophylaxis for prevention of HIV-related infections in Africa (1). Gill et al. focus on recommendations for prophylaxis made by the World Health Organization and the United Nations Programme on HIV/AIDS (UNAIDS) for infants born to mothers with HIV infection, most of whom will not have HIV infection. They examine evidence of benefit, highlight concerns about risk, and propose a model that might be helpful in determining policy in various circumstances. A useful approach in principle but as the authors conclude--important data required for this model remain unavailable, most notably for the magnitude of risk. Other issues, such as national policies and priority setting also...