A Clinical Study and Prognostic Factors for Short-term Survival of Pneumocystis Carinii Pneumonia in Patients with AIDS

Chung, Joo Seop; Cho, Goon Jae; Kwak, Ihm Soo; Rha, Ha Yeon

Abstract

OBJECTIVES
Pneumocystis carinii pneumonia(PCP) is one of the most common life-threatening opportunistic infections in patients with acquired immunodeficiency syndrome(AIDS). This study reports the clinical charac teristics of PCP in the patients with AIDS and prognostic factors for short-term survival of them.
METHODS
We investigated 43 patients of AIDS to evaluate the frequency of PCP in patients in AIDS by retrospective analysis, and classified the 17 patients with PCP into survivors and non-survivors to compare epide miology, clinical characteristics and laboratory findings. We also analyzed whether the these findings influenced the short-term survival in patients with PCP that was combined with AIDS.
RESULTS
In this retrospective study of 43 patients of AIDS, the frequency of PCP in AIDS patients was relatively high as 17 patients(39%), of whom eight pa tients(47%) died of PCP. The epidemiologic findings such as age, route of human immunodeficiency virus(HIV) infection and co-existing disease were not significantly different between survivors and non-survivors. Coughing was the most common symptom and bilateral infiltrates of lung was the most common form in the chest X-ray examination. But these clinical features were similar in the both groups. Total lymphocyte count, CD4 cell count, serum albumin level and arterial oxygen tension were decreased and serum LDH was increased in patients with PCP that was the first episode in patients with AIDS. Lymphocyte and CD4 cell count were significantly lower in the non-survivor group (p=.002 and p=.03, respec tively). Survivors had higher serum albumin level and arterial oxygen tension than non-survivors (p=.02 and p=.04, respectively). And non-survivors were found to have higher serum LDH level than survivors (p=.02).
CONCLUSION
Lymphocyte and CD4 cell counts, serum albumin and LDH, and arterial oxygen tension may be considered as the prognostic factors for short-term sur vival of patients with PCP that is combined with AIDS.