DIAGNOSIS, TREATMENT, AND PREVENTION OF PNEUMOCYSTIS CARINII PNEUMONIA IN HIV-INFECTED PATIENTS

Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

DIAGNOSIS, TREATMENT, AND PREVENTION OF PNEUMOCYSTIS CARINII PNEUMONIA IN HIV-INFECTED PATIENTS

AIDS Updates; 2(2):1-12 1989. Unique Identifier : AIDSLINE ICDB/90657151
Kovacs JA; Critical Care Medicine Dept., NIH, Bethesda, MD

Abstract: P carinii pneumonia has become a major medical problem due to its high incidence in patients (pts) with HIV infection. Pts with HIV infection at risk for P carinii pneumonia as well as physicians caring for such pts should be educated about the clinical manifestations of this disease, and the subtle manner in which it may present. Earlier diagnosis leads to improved survival, and thus pts should be counseled to see a physician even if only minimal symptoms are present, especially if their CD4 count is under 200 cells/mm3. Effective treatment for P carinii pneumonia is available, although the two widely used regimens are associated with a high incidence of adverse reactions. Pts with CD4 counts under 200 cells/mm3 or with a history of P carinii pneumonia should be started on zidovudine, since this drug has clearly been shown to prolong survival and improve quality of life in these pts. Prophylaxis to prevent P carinii pneumonia should also be administered if the combination of zidovudine and a prophylactic agent can be tolerated. Ultimately, however, it will only be by prevention of progression or reversal of the immunosuppression due to HIV that an impact can be made on long-term survival in HIV-infected pts. (112 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS Diagnosis, Differential Human Opportunistic Infections/*DIAGNOSIS/DRUG THERAPY Pneumonia, Pneumocystis carinii/*DIAGNOSIS/DRUG THERAPY JOURNAL ARTICLE REVIEW, TUTORIAL REVIEW
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M9010544

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