Pneumocystis carinii pneumonia. An uncommon cause of death in African patients with acquired immunodeficiency syndrome.
Admissions and deaths in a pulmonary medicine ward in Abidjan, Cote d'Ivoire, West Africa, were evaluated over a 6-month period in 1989 with systematic autopsies on all patients who died. Of 473 patients admitted, 38% were HIV-1 seropositive, 4% were HIV-2 seropositive, and 14% reacted to both viruses. A total of 100 patients (21%) died, and deaths were twice as frequent in HIV-seropositive compared with HIV-negative patients. The pathology of 78 autopsies showed that the predominant cause of death in HIV-seropositive patients was disseminated tuberculosis (40%). Cancer was the cause of death in 64% of HIV-negative patients. Pneumocystosis was found in only 9% of HIV-seropositive autopsies. Since Pneumocystis carinii is an uncommon cause of death in this population, prophylaxis for P. carinii pneumonia is not warranted for HIV-infected patients in Africa. In contrast, research on chemoprophylaxis for tuberculosis is urgently required.
Abouya
Y L
YL
Service de Pneumophtisiologie, Centre Hospitalier, Universitaire de Treichville, Cote d'Ivoire, West Africa.
Beaumel
A
A
Lucas
S
S
Dago-Akribi
A
A
Coulibaly
G
G
N'Dhatz
M
M
Konan
J B
JB
Yapi
A
A
De Cock
K M
KM
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D000367:Age Factors; D002423:Cause of Death; D007560:Cote d'Ivoire / Q000453:epidemiology; D015483:HIV Antibodies / Q000097:blood; D006679:HIV Seropositivity / Q000453:epidemiology / Q000401:mortality; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D009894:Opportunistic Infections / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D015995:Prevalence; D012514:Sarcoma, Kaposi / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D012737:Sex Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000401:mortality / Q000473:pathology
D015483:HIV Antibodies