Temporal Trends and Factors Associated with Survival after Pneumocystis carinii Pneumonia in California, 1983–1992

Colford, John M.; Segal, Mark; Tabnak, Farzaneh; Chen, Mi; Sun, Richard; Tager, Ira
January 1997
American Journal of Epidemiology;1997, Vol. 146 Issue 2, p115
Academic Journal
The authors investigated quarterly trends in survival after the diagnosis of Pneumocystis carinii pneumonia for 19,607 patients in California in the decade from January 1, 1983, through December 31, 1992. Subjects included all cases for whom P. carinii pneumonia was the initial (and only) acquired immunodeficiency syndrome (AIDS)-defining diagnosis as reported to the California human immunodeficiency virus/AIDS surveillance registry. There was a period of rapidly improving survival from approximately June 1986 until April 1988, coincident with the widespread Introduction of antiretroviral therapy (zidovudine) and the Institution of P. carinii pneumonia prophylaxis (with cotrimoxazole and pentamidine). There was no evidence, however, of meaningful improvements in survival for these patients after that period. The association of several covariates (risk transmission group, gender, race/ethnicity, certainty of P. carinii pneumonia diagnosis, age, region of residence, availability of CD4 count, and level of CD4 count) were also studied both by proportional hazards regression and by recursive partitioning (i.e., tree-based) survival analysis. The availability of a CD4 count (regardless of its level) was the single factor most strongly associated with survival (median survival 36 months among those with and 14 months among those without reported CD4 counts, p <0.05). Data from this large, population-based surveillance registry of AIDS in California suggest that, despite earlier improvements in survival after the diagnosis of P. carinii pneumonia, the long-term survival of these patients remains poor (39% alive 2 years after diagnosis) and that no improvement in survival has occurred since 1988. Am J Epidemiol 1997;146:115–27.


Related Articles

  • Pneumocystis carinii Pneumonia: A Clinical Review. Wilkin, Aimee; Feinberg, Judith // American Family Physician;10/15/1999, Vol. 60 Issue 6, p1699 

    Discusses about Pneumocystis carinii pneumonia (PCP). Description of the infection; Risk factors and clinical presentation; Diagnosis; Management of PCP.

  • Risk Factors for Community-Acquired Pneumonia among Persons Infecte with Human Immunodeficiency... Navin, Thomas R.; Rimland, David; Lennox, Jeffrey L.; Jernigan, John; Cetron, Marty; Hightower, Allen; Roberts, Jacqueline M.; Kaplan, Jonathan E. // Journal of Infectious Diseases;1/1/2000, Vol. 181 Issue 1, p158 

    Analyzes risk factors associated with community-acquired pneumonia among persons infected with HIV. Possible pulmonary damages caused by the antecedent infection; Relationship between the anti-fungal agent fluconazole and the protective effect of the drug to pneumonia; Genetic sequence distinct...

  • Risk factors of Pneumocystis jeroveci pneumonia in patients with systemic lupus erythematosus. Lertnawapan, Ratchaya; Totemchokchyakarn, Kitti; Nantiruj, Kanokrat; Janwityanujit, Suchela // Rheumatology International;Mar2009, Vol. 29 Issue 5, p491 

    Pneumocystis jeroveci pneumonia (PCP) is an opportunistic infection which occurs mostly in the immune-deficiency host. Although PCP infected systemic lupus erythematosus (SLE) patient carries poor outcome, no standard guideline for prevention has been established. The aim of our study is to...

  • Dynamics of Pneumocystis carinii Air Shedding During Experimental Pneumocystosis. Choukri, Firas; Aliouat, El Moukhtar; Menotti, Jean; Totet, Anne; Gantois, Nausicaa; Garin, Yves J. F.; Bergeron, Vance; Dei-cas, Eduardo; Derouin, Francis // Journal of Infectious Diseases;May2011, Vol. 203 Issue 9, p1333 

    To better understand the diffusion of Pneumocystis in the environment, airborne shedding of Pneumocystis carinii in the surrounding air of experimentally infected rats was quantified by means of a real-time polymerase chain reaction assay, in parallel with the kinetics of P. carinii loads in...

  • Clinical characteristics and risk factors for Pneumocystis jirovecii pneumonia in patients with rheumatoid arthritis receiving adalimumab: a retrospective review and case–control study of 17 patients. Watanabe, Kaori; Sakai, Ryoko; Koike, Ryuji; Sakai, Fumikazu; Sugiyama, Haruhito; Tanaka, Michi; Komano, Yukiko; Akiyama, Yuji; Mimura, Toshihide; Kaneko, Motohide; Tokuda, Hitoshi; Iso, Takenobu; Motegi, Mitsuru; Ikeda, Kei; Nakajima, Hiroshi; Taki, Hirofumi; Kubota, Tetsuo; Kodama, Hirotaka; Sugii, Shoji; Kuroiwa, Takashi // Modern Rheumatology (Springer Science & Business Media B.V.);Nov2013, Vol. 23 Issue 6, p1085 

    Objectives: To investigate the clinical characteristics and risk factors of Pneumocystis jirovecii pneumonia (PCP) in rheumatoid arthritis (RA) patients treated with adalimumab. Methods: We conducted a multicenter, retrospective, case–control study to compare RA patients treated with...

  • Race/ethnicity and HAART initiation in a military HIV infected cohort. Johnson, Erica N.; Roediger, Mollie P.; Landrum, Michael L.; Crum-Cianflone, Nancy F.; Weintrob, Amy C.; Ganesan, Anuradha; Okulicz, Jason F.; Macalino, Grace E.; Agan, Brian K. // AIDS Research & Therapy;2014, Vol. 11, p1 

    Background Prior studies have suggested that HAART initiation may vary by race/ethnicity. Utilizing the U.S. military healthcare system, which minimizes confounding from healthcare access, we analyzed whether timing of HAART initiation and the appropriate initiation of primary prophylaxis among...

  • Risk Factor Analyses for Immune Reconstitution Inflammatory Syndrome in a Randomized Study of Early vs. Deferred ART during an Opportunistic Infection. Grant, Philip M.; Komarow, Lauren; Andersen, Janet; Sereti, Irini; Pahwa, Savita; Lederman, Michael M.; Eron, Joseph; Sanne, Ian; Powderly, William; Hogg, Evelyn; Suckow, Carol; Zolopa, Andrew // PLoS Clinical Trials;Jul2010, Vol. 7 Issue 7, Special section p1 

    Background: Immune reconstitution inflammatory syndrome (IRIS) is reported widely in patients initiating antiretroviral therapy (ART). However, few studies are prospective, and no study has evaluated the impact of the timing of ART when allocated randomly during an acute opportunistic infection...

  • The Effect of AIDS Clinical Trials Group Protocol 5164 on the Time From Pneumocystis jirovecii Pneumonia Diagnosis to Antiretroviral Initiation in Routine Clinical Practice: A Case Study of Diffusion, Dissemination, and Implementation. Geng, Elvin H.; Kahn, James S.; Chang, Olivia C.; Hare, C. Bradley; Christopoulos, Katerina A.; Jones, Diane; Petersen, Maya L.; Deeks, Steven G.; Havlir, Diane V.; Gandhi, Monica // Clinical Infectious Diseases;11/15/2011, Vol. 53 Issue 10, p1008 

    Background. Diffusion, dissemination, and implementation of scientific evidence into routine clinical practice is not well understood. The Adult AIDS Clinical Trials Group (ACTG) Protocol 5164 showed that early antiretroviral therapy (ART; ie, within 14 days) after diagnosis of an opportunistic...

  • The use of genetic markers to characterize transmission of pneumocystis carinii. Baughman, Robert P.; Keely, Scott P. // AIDS Patient Care & STDs;Jun97, Vol. 11 Issue 3, p131 

    Presents information on the disease known as pneumocystis carinii (P. carinii). Details on ways in which pneumocystis carinii affects (HIV) human immunodeficiency virus-infected persons; Discussion on the development of several drugs to control the disease; Indepth look at reactivation as...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics