[Impact of zidovudine treatment and the pneumocystis carinii prophylaxis in natural history of patients with HIV infection].

Abstract

INTRODUCTION:

Early use of prophylactic regimens against Pneumocystis carinii and zidovudine therapy, may have modified the natural history of patients with HIV-1 infection. We describe the incidence of opportunistic infections and analize the mortality rate in those patients to check the occurrence of any change in the above mentioned natural history.

PATIENTS:

Clinical charts of patients with HIV-1 infection attending our hospital are reviewed, from november 1987 to june 1994.

RESULTS:

We found 200 patients with AIDS, documenting 64 (32%) deaths and 69 (34.5%) patients lost to follow-up. Seven HIV-1 infected patients (3.5%) received primary prophylaxis against Pneumocystis carinii and 17 (8.5%) zidovudine therapy before developing AIDS. Patients with AIDS receiving zidovudine therapy had a higher survival (median 50 months) than those not receiving such therapy (median 17 months; p < 0.001). Ninety one patients with tuberculosis receiving zidovudine therapy had also a higher survival than those not receiving antirretroviral therapy (p < 0.01). Eighty six patients with Pneumocystis carinii pneumonia receiving zidovudine had also a higher survival (p < 0.001). Likewise, patients on zidovudine treatment had a lower reduction on CD4 lymphocyte count.

CONCLUSIONS:

The spectrum of AIDS-defining illnesses is similar to the whole country. We have not found any difference in the incidence of opportunistic infections, but we observed a trend to reduction in the incidence rate of PCP. The introduction of zidovudine therapy seems to have a positive influence on the survival of AIDS patients. This advantage is highlighted in those patients more immunodeficients at first.

• Authors: E Sáiz Hervas, V Castilla Castellano, J Miquel Plaza, A M Benito Blanco, M M Martín Llorens, M Pastor de Blas, P Izquierdo, M A Muñoz Jareño, A Sierra, M A Nieto, A M Moreno Collado, C Fraguas
• Journal: Anales de medicina interna (Madrid, Spain : 1984) (An Med Interna) Vol. 15 Issue 3 Pg. 132-7 (Mar 1998) ISSN: 0212-7199 [Print] Spain
• Vernacular Title: Influencia del tratamiento con zidovudina y de la profilaxis contra Pneumocystis carinii en la historia natural de los enfermos con infección por VIH.
• PMID: 9580410 (Publication Type: English Abstract, Journal Article)

Chemical References

• Anti-HIV Agents
• Zidovudine

Topics

• AIDS-Related Opportunistic Infections (prevention & control)
• Anti-HIV Agents (therapeutic use)
• HIV Infections (drug therapy, immunology)
• HIV-1
• Humans
• Pneumonia, Pneumocystis (prevention & control)
• Zidovudine (therapeutic use)