To the Editor.
—The report by Simonds et al1 on the epidemiology of PCP in children with perinatally acquired HIV infection is extremely valuable for the clinical care of these patients. However, one important question that could be answered by their data is not addressed: At what age should PCP prophylaxis be initiated? The current recommendations issued by the Centers for Disease Control and Prevention2 state clearly that "because PCP rarely occurs among infants <1 month of age," and considering the possible toxic effects of prophylactic agents in neonates, PCP prophylaxis, when indicated, should not begin until after 1 month of age. Simonds et al state that "prophylaxis should begin in the first months of life." It is not clear from the data presented whether or not any cases were documented to occur within the first month of life; their Fig 2 suggests some cases did occur at
Meyers A. Pneumocystis carinii Pneumonia in Children With Perinatally Acquired HIV Infection. JAMA. 1994;271(2):103. doi:10.1001/jama.1994.03510260026015