FEATURES AND OUTCOME OF PNEUMOCYSTIS-CARINII PNEUMONIA ACCORDING TO RISK CATEGORY FOR HIV-INFECTION

A retrospective study of Pneumocystis carinii pneumonia (PCP) was unde rtaken to examine differences between the presentation and outcome of PCP in AIDS patients from different risk categories for HIV infection, There were 176 PCP episodes recorded in 126 patients from the followi ng risk categories: 69 intravenous drug misusers (IDMs), 36 homosexual ly infected men and 21 heterosexually infected patients, Most clinical features did not differ significantly between the 3 groups but hyperc apnia was almost exclusively seen in IDMs and, if recorded, was associ ated with a poorer survival. Pneumothorax was more likely to complicat e PCP in IDMs and, although present in all groups, concomitant bacteri al respiratory infections were more common in IDMs. Recovery from PCP and the incidence of adverse events during treatment did not differ ac cording to risk category, Subsequent survival time was shorter amongst IDMs, but the uptake of antiretrovirals in this group was significant ly lower, We conclude that there are few differences in the presentati on of PCP between IDMs and other risk categories for HIV infection and that these do not influence the outcome of illness, The lower post-PC P survival in IDMs can be accounted for by a reduced uptake of antiret roviral drugs by this group.