BACILLARY ANGIOMATOSIS AND BACILLARY PELIOSIS IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS - CLINICAL CHARACTERISTICS IN A CASE-CONTROL STUDY

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.