AEGiS-11IAC: Pneumocystis carinii pneumonia as first AIDS indicator disease in the era of primary prophylaxis

AEGiS-11IAC: Pneumocystis carinii pneumonia as first AIDS indicator disease in the era of primary prophylaxis - why does it still occur?

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Pneumocystis carinii pneumonia as first AIDS indicator disease in the era of primary prophylaxis - why does it still occur?

Int Conf AIDS 1996 Jul 7-12; 11:229 (abstract no. Tu.B.113)
Flepp M, Ledergerber B, Schenker C, Egger M, Gebhardt M, Luthy R; Division of Infectious Diseases, University Hospital, Zurich, Switzerland. Fax: 255 44 99.

OBJECTIVE: To examine characteristics of patients diagnosed with PcP as first clinical AIDS indicator disease in Switzerland 1993 and 1994.

METHODS: Identification of cases in the SHCS database supplemented with a retrospective chart review. Criteria defined as indication for primary prophylaxis (PP): CD4+ cell count less than 200/ul and/or CD4+ cell count less than 14% and/or oral candidiasis and/or oral hairy leucoplakia within one year of diagnosis.

RESULTS: 145 cases, representing 57% (145/256) of all first AIDS indicator diseases (CDC-87) reported to the SFOPH for the same time period. 108 patients were male and 37 (26%) female. Risk factors for HIV infection: Homosexual contacts 63 (43%), heterosexual contacts 33 (23%), needle sharing 43 (30%) and other 6 (4%). 134/145 (92%) did not receive PP at the time of PcP diagnosis. 116/145 (80%) had never received PP (table: see text) and 18/145 (12%) either had stopped PP greater than or equal to2 months (10) or started less than 2 months (4) or lacked compliance (4) before they developed PcP. Only 11/145 (8%) patients developed PcP while receiving PP, and 9 of these were not receiving cotrimoxazole. (table: see text)

CONCLUSIONS: The overwhelming majority of patients with PcP did not have PP at diagnosis with a large proportion not knowing about their HIV infection. Preventive strategies should encourage persons at risk to test for HIV infection and infected persons to have regular medical and immunological assessments.

Keywords: AEGIS, Pneumonia, Pneumocystis carinii, CD4 Lymphocyte Count, HIV Infections, Trimethoprim-Sulfamethoxazole Combination, Candidiasis, Oral, Heterosexuality, Retrospective Studies, Anti-HIV Agents, Risk Factors, Leukoplakia, Hairy, Chemoprevention, Needle Sharing, First Aid, Switzerland, Female, Male, Human, prevention & control, therapy, diagnosis, drug therapy, ICA11

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TuB113