Happens among HIV-negative people. But only with concomitant very
serious disease. And there are some more hopeful differences for HIV+
people in terms of potential to survive PCP.
But clearly, there ARE differences between people with HIV and those
who are HIV-negative.
George M. Carter
http://gateway.nlm.nih.gov/MeetingAb...102195044.html
Comparison of pneumocystis carinii pneumonia (PCP) in HIV-positive and
HIV-negative immunocompromized patients.
Bellini C, Nuesch R, Zimmerli W.
Tenth Int Symp Infect Immunocompromised Host 21 24 June 1998 Davos
Switz Int Symp Infect Immunocompromised Host 10 1998 Davos Switz. 1998
Jun 21-24; 10: (abstract no. 052).
Division of Infectious Diseases, University Hospitals, Basel,
Switzerland.
Objective: PCP is decreasing in AIDS-patients, but increasing in
severely immunocompromized HIV-negative individuals. We compared the
clinical picture and prognosis of PCP in HIV-positive and HIV-negative
patients. Method: From 1983-95, 103 patients were treated for PCP at
our institution. 92 records, 75 from HIV-positive and 17 from
HIV-negative patients were available for the retrospective study.
Results: At time of diagnosis, 84% of the HIV-infected patients had
<200/microliter CD4+ lymphocytes. HIV-negative individuals had the
following underlying diseases: Renal transplantation (n=8),
bone-marrow transplantation (n=5), and various conditions (n=4)
including idiopathic CD4-cytopenia. Several features were more
frequent in HIV-positive patients: Cachexia (49 vs 21%, P<.05),
thoracic pain (41 vs 8%, p<.02), expectoration (51 vs 25%, p<.05),
tachypnea (45 vs 14%, p<.04), and hypoxemia (paO2<9.5 kPa) (81% vs
50%). Nevertheless, the median duration of hospitalization was shorter
in HIV-positive than HIV-negative patients (21 vs 34 days). Less
HIV-positive patients had to be ventilated (16% vs 29%) and less of
the HIV-positive ventilated patients died (25% vs. 80%). Similarly,
the overall mortality of HIV-positive patients was somewhat lower (12%
vs 29.4%, p=.08). Conclusion: AIDS-patients with PCP had more
respiratory symptoms, but a better prognosis than HIV-negative
patients. This may be due to higher age, more severe underlying
disease, or delayed diagnosis in immuno-compromized HIV-negative
individuals.
