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Performance Measure: PCP Prophylaxis for HIV Exposed Infants

National Quality Forum #: None

Description: Percentage of eligible infants1 who are born to women with HIV infection and were prescribed Pneumocystitis carnii pneumonia (PCP) prophylaxis in the measurement year

Numerator: Number of infants who are born to women with HIV and were prescribed PCP prophylaxis during the measurement year

Denominator: Number of infants born to women with HIV:

  • In whom HIV infection has not been presumptively excluded2 by 6 weeks of age
  • Had a medical visit with a provider with prescribing privileges3 at least once in the measurement year

Patient Exclusions: Patients who are diagnosed with HIV infection

Data Elements:

  1. Was the infant seen by a provider with prescribing privileges during the measurement year? (Y/N)
    1. Was the infant born to a woman with HIV infection? (Y/N)
      1. If yes, was the infant ≥ 6 weeks of age at any point during the measurement year? (Y/N)
        1. If yes, was HIV presumptively excluded by six weeks of age? (Y/N)
          1. If no, was the infant prescribed PCP prophylaxis during the measurement year? (Y/N)
            1. If yes, list the date

Data Sources:

  • Electronic medical record/electronic health record
  • CAREWare, Lab Tracker, or other electronic database
  • Medical record data abstraction of a sample of records
  • Billing records

National goals, targets, or benchmarks for comparison

The HIV Quality Measures (HIVQM) Module is a tool within the Ryan White HIV/AIDS Services Report portal. It allows recipients to enter aggregate data specific to HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Outcome measures for consideration

  • Rate of PCP in the clinic population
  • HIV-related mortality rates

Basis for selection

"Infants with indeterminate HIV infection status should receive prophylaxis until they are determined to be HIV-uninfected or presumptively HIV-uninfected (AIII)."2

Department of Health and Human Service Clinical Practice Guidelines

"Chemoprophylaxis is highly effective in preventing PCP. Criteria for its use are based on a patient's age and CD4 count or percentage. Prophylaxis is recommended for all HIV-infected children aged ≥6 years who have CD4 T lymphocyte (CD4) counts <200 cells/mm3 or CD4 percentage <15%, for children aged 1 to <6 years with CD4 counts <500 cells/mm3 or CD4 percentage <15%, and for all HIV-infected infants aged <12 months regardless of CD4 count or percentage (AII)."4

"Infants born to HIV-infected mothers should be considered for prophylaxis beginning at 4 to 6 weeks of age… Infants with indeterminate HIV infection status should receive prophylaxis until they are determined to be definitively HIV-uninfected or presumptively HIV-uninfected (AIII). Prophylaxis is not recommended for infants who meet criteria for being definitively or presumptively HIV-uninfected."2

Use in other federal programs

None

References/notes

1 "Infants" includes all patients 12 months of age or younger.

2 Panel on Opportunistic Infections in Children with and Exposed to HIV. Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV (PDF - 6 MB). Department of Health and Human Services. Available online. Accessed online. August 2022. W-4 and W-15.

3 A "provider with prescribing privileges" is a health care professional who is certified in his/her jurisdiction to prescribe medications.

4 Panel on Opportunistic Infections in Children with and Exposed to HIV. Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV (PDF - 6 MB). Department of Health and Human Services. Available online. Accessed August 2022. W-1.

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