EFFECT OF PNEUMOCYSTIS-CARINII PROPHYLAXI S ON THE CLINICAL AND BIOLOGICAL AIDS PRESENTATION - 624 OBSERVATIONS FROM THE AQUITAINE COHORT (FRANCE, 1985-1994)

In a cohort of HIV-infected patients, this study compares the clinical and immunological features at the time of AIDS diagnosis of patients who either received primary Pneumocystis carinii prophylaxis (P+; n = 335) or who did not (P-; n = 289). Frequency of P carinii pneumonia wa s lower in P+ than in P-patients (14.9% vs 26.0%; p < 0.001). Converse ly, toxoplasmic encephalitis, esophageal candidiasis, cytomegalovirus disease and M avium complex disease were more frequent in P+ patients. CD4+ count (median/mm(3)) at the time of AIDS diagnosis was lower in P+ than in P-patients: 22 vs 97 (p < 0.001), this suggests that early intervention delays the onset of AIDS for about one year. While search ing for new prevention strategies against other opportunistic infectio ns, efforts should be expanded to improve prophylaxis of P carinii pne umonia which remains in France the the most frequent first AIDS-relate d illness.