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Influence of specific prophylaxis on diagnosis of Pneumocystis carinii pneumonia (PCP) infected patients.
Chouaid C; Schuller MP; Febvre M; Urban T; Lebeau B; Pulmonary
December 30, 1992
Int Conf AIDS. 1992 Jul 19-24;8(3):66 (abstract no. PuB 7105). Unique

OBJECTIVE: To determine the influence of specific prophylaxis on the diagnosis of PCP in HIV patients. METHODS: Prospective study of clinical, radiological, gasometric and biological characteristics of PCP, together with the sensitivity of induced sputum (IS) and bronchoalveolar lavage (BAL) in patients with and without specific prophylaxis. PATIENTS: 98 cases of PCP diagnosed between January 1, 1990 and December 31, 1991. 77 patients were receiving no prophylaxis at the time of diagnosis; 11 patients were receiving primary prophylaxis and 10 patients were receiving secondary prophylaxis with, in all cases 300 mg of aerosolized Pentacarinate every four weeks. RESULTS: There was no significant difference between the prophylaxis and no prophylaxis groups in terms of duration of symptoms before diagnosis, functional signs, chest X-ray findings, or resting partial oxygen pressure in ambient air. In contrast the sensitivity of IS was lower in patients undergoing prophylaxis. .37 versus .63 in patients without prophylaxis (p less than 0.05). With a minimum follow up of one month, none of the patient with negative tests for P. carinii in the BAL fluid has developed PCP (perfect sensitivity of BAL). CONCLUSION: The diagnostic strategy in HIV infected patients, suspected of PCP, under specific prophylaxis should be the same that in HIV patients without prophylaxis.

Aerosols Bronchoalveolar Lavage Fluid Human HIV Infections/*COMPLICATIONS Pneumonia, Pneumocystis carinii/COMPLICATIONS/DIAGNOSIS/ *PREVENTION & CONTROL Prospective Studies Sensitivity and Specificity ABSTRACT