Survival of patients with AIDS, after diagnosis of Pneumocystis carinii pneumonia, in the United States
Survival of patients with AIDS, after diagnosis of Pneumocystis carinii pneumonia, in the United States
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DOI：
10.1086/319866
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发表时间：
2001-05-01
影响因子：
6.4
通讯作者：
Navin, TR
中科院分区：
文献类型：
--
作者：
Dworkin, MS;Hanson, DL;Navin, TR
为了研究卡氏肺孢子虫肺炎（PCP）诊断后的生存率以及与早期死亡（PCP诊断后一个月内或一个月内）相关的因素，分析了成人和青少年谱系HIV疾病项目的数据。在随访期间（1992-1998年），在4412例5222次PCP发作的患者中，诊断后>1个月的生存率为82%，诊断后≥ 12个月的生存率为47%; 12个月生存率从1992-1993年的40%增加到1996-1998年的63%。多因素Logistic回归分析显示，早期死亡与PCP病史有关（比值比[OR]，1.4），年龄45-59岁（OR，1.9）或大于或等于60岁（OR，3.7），CD 4细胞计数0-24个细胞/穆尔（PCP前小于或等于5个月; OR，1.8）或25-49个细胞/穆尔（OR，1.4）（P < .05）。联合抗逆转录病毒治疗（OR，0.2）和其他抗逆转录病毒治疗（OR，0.4）与早期生存相关。这项研究表明，尽管出现了抗药性突变卡氏肺孢子虫菌株，但近年来诊断为PCP后的存活率有所提高。
To examine survival after diagnosis of Pneumocystis carinii pneumonia (PCP) and factors associated with early death (during the month of or the month after diagnosis of PCP), data were analyzed from the Adult and Adolescent Spectrum HIV Disease project. Among 4412 patients with 5222 episodes of PCP during follow-up (1992-1998), survival at >1 month after diagnosis was 82%, and survival at greater than or equal to 12 months after diagnosis was 47%; 12-month survival increased from 40% in 1992-1993 to 63% in 1996-1998. By multiple logistic regression analysis, early death was associated with history of PCP (odds ratio [OR], 1.4), age 45-59 years (OR, 1.9) or greater than or equal to 60 years (OR, 3.7), and CD4 cell count of 0-24 cells/muL (less than or equal to5 months before PCP; OR, 1.8) or 25-49 cells/muL (OR, 1.4) (P < .05). Concurrent prescription of combination an tiretroviral therapy (OR, 0.2) and other antiretroviral therapy (OR, 0.4) was associated with surviving the early period. This study shows improved survival after diagnosis of PCP in recent years, despite emergence of antibiotic-resistant mutant P. carinii strains.