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:
- Was the infant seen by a provider with prescribing privileges during the measurement year? (Y/N)
- Was the infant born to a woman with HIV infection? (Y/N)
- If yes, was the infant ≥ 6 weeks of age at any point during the measurement year? (Y/N)
- If yes, was HIV presumptively excluded by six weeks of age? (Y/N)
- If no, was the infant prescribed PCP prophylaxis during the measurement year? (Y/N)
- If yes, list the date
- If no, was the infant prescribed PCP prophylaxis during the measurement year? (Y/N)
- If yes, was HIV presumptively excluded by six weeks of age? (Y/N)
- If yes, was the infant ≥ 6 weeks of age at any point during the measurement year? (Y/N)
- Was the infant born to a woman with HIV infection? (Y/N)
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 - 4 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 - 4 MB). Department of Health and Human Services. Available online. Accessed August 2022. W-1.