       Document 0648
 DOCN  M9650648
 TI    Clinical characteristics and outcome of Pneumocystis carinii pneumonia
       in HIV-infected and otherwise immunosuppressed patients.
 DT    9605
 AU    Ewig S; Bauer T; Schneider C; Pickenhain A; Pizzulli L; Loos U; Luderitz
       B; Department of Internal Medicine, University of Bonn, Germany.
 SO    Eur Respir J. 1995 Sep;8(9):1548-53. Unique Identifier : AIDSLINE
       MED/96120041
 AB    The factors contributing to unequal mortality rates following
       Pneumocystis carinii pneumonia (PCP) in different groups at risk are
       poorly understood. We therefore compared the first episodes of PCP
       without prophylaxis in human immunodeficiency virus infected (HIV) and
       otherwise immunosuppressed patients in this retrospective study. A total
       of 58 HIV-infected and 16 otherwise immunosuppressed patients were
       analysed. The comparison included epidemiological, clinical, laboratory,
       radiological and microbiological data, as well as therapy and clinical
       course. A prognostic analysis was performed using a logistic regression
       model. The mortality was significantly different in the two groups (HIV
       group 17 versus non-HIV group 50%). Renal transplant patients had a
       higher survival rate as compared to malignancy or collagen vascular
       disease as underlying diseases at risk. Acute respiratory failure was
       more common in the non-HIV group. Variables found to be significantly
       associated with lethal outcome in univariate analysis were alveolar to
       arterial pressures difference for oxygen (P(A-a),O2), haemoglobin,
       platelet count, total protein, serum albumin, and gamma-globulins in the
       HIV-group, and serum albumin in the non-HIV group. In the multivariate
       analysis of the HIV group, platelet count and gamma-globulins remained
       independent prognostic factors. In conclusion, in the HIV-group,
       mortality is closely related to the severeness of PCP as well as to the
       severeness of the acquired immune deficiency syndrome (AIDS) disease. In
       the non-HIV group, malignancy and collagen vascular disease as
       underlying conditions at risk account for the high mortality rate. Its
       severeness was mainly reflected by serum albumin, which represented the
       only variable found to be significantly associated with death in both
       groups.
 DE    Adolescence  Adult  Aged  Analysis of Variance  Antibiotics/THERAPEUTIC
       USE  AIDS-Related Opportunistic Infections/MORTALITY/*PHYSIOPATHOLOGY/
       THERAPY  Comparative Study  Female  Human  Immunocompromised Host
       Logistic Models  Male  Middle Age  Pneumonia, Pneumocystis
       carinii/MORTALITY/*PHYSIOPATHOLOGY/  THERAPY  Prognosis  Respiration,
       Artificial  Retrospective Studies  Risk Factors  Survival Rate  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

