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Survival
of Patients with AIDS After Diagnosis of Pneumocystis carinii
Pneumonia in the Unites States [Dworkin MS, et al. JID
2001;183:1409]: This
is a report from the CDC-sponsored Adult and Adolescent Spectrum
HIV Disease Project. The investigators examined survival after diagnosis
of P. carinii pneumonia for 5,222 episodes from 1992 through
1998. The one-month survival was 82%, and survival at 12 months
was 47%. As expected, the 12-months survival increased from 40%
in 1992 to 68% in 1998. Risk factors for early death were history
of PCP, age > 45 years, CD4 cell count <25/mm3,
and lack of antiretroviral therapy.
Comment: The authors point out that the short-term mortality
for PCP has not changed, which should be somewhat reassuring in
the face of reports of increasing resistance of P. carinii
to TMP-SMX [Lancet 1999;354:1347]. However, it is also important
to acknowledge that the mortality rate attributed to PCP is about
18%, which is somewhat humbling when most feel this is a condition
for which we have good treatment.
posted
5/16/2001
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