BACILLARY ANGIOMATOSIS AND BACILLARY PELIOSIS IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS - CLINICAL CHARACTERISTICS IN A CASE-CONTROL STUDY
Jc. Mohleboetani et al., BACILLARY ANGIOMATOSIS AND BACILLARY PELIOSIS IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS - CLINICAL CHARACTERISTICS IN A CASE-CONTROL STUDY, Clinical infectious diseases, 22(5), 1996, pp. 794-800
Clinical characteristics associated with bacillary angiomatosis and ba
cillary peliosis (BAP) in patients with human immunodeficiency virus (
HIV) infection were evaluated in a case-control study; 42 case-patient
s and 84 controls were matched by clinical care institution. Case-pati
ents presented with fever (temperature, >37.8 degrees C; 93%), a media
n CD4 lymphocyte count of 21/mm(3), cutaneous or subcutaneous vascular
lesions (55%), lymphadenopathy (21%), and/or abdominal symptoms (24%)
, Many case-patients experienced long delays between medical evaluatio
n and diagnosis of BAP (median, 4 weeks; range, 1 day to 24 months). C
ase-patients were more likely than controls to have fever, lymphadenop
athy, hepatomegaly, splenomegaly, a low CD4 lymphocyte count, anemia,
or an elevated serum level of alkaline phosphatase (AP) (P < .001). In
multivariate analysis, a CD4 lymphocyte count of <200/mm(3) (matched
odds ratio [OR], 9.9; P < .09), anemia reflected by a hematocrit value
of <0.36 (OR, 19.7; P < .04), and an elevated AP level of greater tha
n or equal to 2.6 mu kat/L (OR, 23.9; P < .05) remained associated wit
h disease after therapy with zidovudine was controlled for. BAP should
be considered an AIDS-defining opportunistic infection and should be
included in the differential diagnosis for febrile, HIV-infected patie
nts with cutaneous or osteolytic lesions, lymphadenopathy, abdominal s
ymptoms, anemia, or an elevated serum level of AP.