TY - JOUR
T1 - Predictors of Pneumocystis carinii pneumonia in HIV-infected persons
AU - Stansell, John D.
AU - Osmond, Dennis H.
AU - Charlebois, Edwin
AU - Lavange, Lisa
AU - Wallace, Jeanne M.
AU - Alexander, Barbara V.
AU - Glassroth, Jeffrey
AU - Kvale, Paul A.
AU - Rosen, Mark J.
AU - Reichman, Lee B.
AU - Turner, Joan R.
AU - Hopewell, Philip C.
AU - Merrifield, Cynthia
AU - Mossar, Melinda
AU - Hirschtick, Robert E
AU - Meiselman, Lori
AU - Manghisi, Kim K.
AU - Cardozo, Christopher
AU - Kalb, Thomas H.
AU - Mangura, Bonita T.
AU - Barnes, Saundra
AU - Shapiro, Bert
AU - LeMaire, Barbara
AU - Richer, Barbara
AU - Au, Janet
AU - Coulson, Anne
AU - Markowitz, Norman
AU - Saravolatz, Louis D.
AU - Johnson, Christine
AU - Huitsing, Joanne
AU - Krystoforski, Ann Marie
AU - Kenneth Poole, W.
AU - Vijaya Rao, A.
AU - Clayton, Kim
AU - Hansen, Nellie I.
AU - Jordan, Matthew C.
AU - Thompson, Jim
AU - Myers, David
AU - Katzin, Judith
AU - Fulkerson, William
AU - Wilcosky, Tim
AU - Kalica, Anthony R.
AU - Wittes, Janet
AU - Follmann, Dean A.
AU - Wise, Robert
PY - 1997
Y1 - 1997
N2 - The Pulmonary Complications of HIV Infection Study is a prospective, multicenter, observational study evaluating pulmonary disease among HIV- infected persons. For approximately 52 mo, 1,182 HIV-infected subjects were followed. All participants were evaluated for pulmonary disease on a predetermined schedule. There were 145 episodes of Pneumocystis carinii pneumonia (PCP). Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/μl and 95% had CD4 counts less than 200/μl. Subtle changes in diffusing capacity for carbon monoxide (DL(CO)) were associated with PCP. Univariate analysis identified recurrent undiagnosed fevers, night sweats, oropharyngeal thrush, and unintentional weight loss to be associated with risk among persons with CD4 counts above 200/μl. Subjects in whom CD4 counts declined to below 200/μl and who were not receiving preventive therapy were nine times more likely to develop PCP within 6 mo compared with subjects who received such therapy. A strong trend toward differences between the sexes was detected. Black subjects had less than one third the risk of developing PCP as did white subjects (p < 0.0001). There was no significant difference in risk by HIV transmission category, study site, frequency of follow-up, age, education, smoking history, or use of antiretroviral therapy. Multivariable analysis revealed low CD4 lymphocyte count (p < 0.0001), use of prophylaxis (p < 0.0001), racial differences (p < 0.0001), and declining DL(CO) (p = 0.015) to influence risk. Constitutional signs and symptoms indicate increased risk for PCP among HIV-infected persons with CD4 counts above 200/μl.
AB - The Pulmonary Complications of HIV Infection Study is a prospective, multicenter, observational study evaluating pulmonary disease among HIV- infected persons. For approximately 52 mo, 1,182 HIV-infected subjects were followed. All participants were evaluated for pulmonary disease on a predetermined schedule. There were 145 episodes of Pneumocystis carinii pneumonia (PCP). Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/μl and 95% had CD4 counts less than 200/μl. Subtle changes in diffusing capacity for carbon monoxide (DL(CO)) were associated with PCP. Univariate analysis identified recurrent undiagnosed fevers, night sweats, oropharyngeal thrush, and unintentional weight loss to be associated with risk among persons with CD4 counts above 200/μl. Subjects in whom CD4 counts declined to below 200/μl and who were not receiving preventive therapy were nine times more likely to develop PCP within 6 mo compared with subjects who received such therapy. A strong trend toward differences between the sexes was detected. Black subjects had less than one third the risk of developing PCP as did white subjects (p < 0.0001). There was no significant difference in risk by HIV transmission category, study site, frequency of follow-up, age, education, smoking history, or use of antiretroviral therapy. Multivariable analysis revealed low CD4 lymphocyte count (p < 0.0001), use of prophylaxis (p < 0.0001), racial differences (p < 0.0001), and declining DL(CO) (p = 0.015) to influence risk. Constitutional signs and symptoms indicate increased risk for PCP among HIV-infected persons with CD4 counts above 200/μl.
UR - http://www.scopus.com/inward/record.url?scp=8044223403&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=8044223403&partnerID=8YFLogxK
U2 - 10.1164/ajrccm.155.1.9001290
DO - 10.1164/ajrccm.155.1.9001290
M3 - Article
C2 - 9001290
AN - SCOPUS:8044223403
VL - 155
SP - 60
EP - 66
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
SN - 1073-449X
IS - 1
ER -