AEGiS-1IAC: SIGNIFICANCE OF PERSISTENCE OF P. CARINII AFTER COMPLETION OF TREATMENT

1st International AIDS Conference

Atlanta, Georgia, U.S.A. - April 14-17, 1985

SIGNIFICANCE OF PERSISTENCE OF P. CARINII AFTER COMPLETION OF TREATMENT

Int Conf AIDS 1985 Apr 14-17; 1:23 (abstract no. S4B)

Philip Michael, H Brodie, M Wharton, C Bryant, C Wofsy, P Hopewell
University California, San Francisco.

The optimum duration of treatment for P. carinii pneumonia (PCP) in patients (pts) with AIDS has not been established. It has been suggested that persistence of organisms after 3 weeks of therapy is an indication to prolong treatment. To determine if this was correct, we performed bronchoscopy after 3 weeks of therapy for PCP, in 28 prospectively enrolled pts, and compared survival according to the presence or absence of persistent organisms. PCP was present in 17(61%)(Group A) and absent in 11(39%)(Group B). At the time of life table analysis, 3 of Group A were alive, 5.5, 7.0 and 7.9 mos after the bronchoscopy; 5 of Group B were alive, 5.5, 9.8, 11.4, 11.5 and 17.5 mos after the bronchoscopy; and the remaining pts had died. The median survival was 6.85 mos for Group A and 10.33 mos for Group B (P=0.09 generalized Wilcoxon, P=0.03 generalized Savage). Five Group A pts(Group A1) were treated an additional 5-14 days, whereas 12 (Group A2) had no further therapy. Median survival was 3.8 mos in Group A1 and 7.4 mos in Group A2 (P=0.16 generalized Wilcoxon, P=0.23 generalized Savage). We conclude that although the difference in survival between Groups A and B is of marginal statistical significance, prolonging treatment 5-14 days beyond 3 wks does not improve survival in pts with PCP detected after treatment compared to pts without PCP after treatment.

850414
S4B