CD4+ cells and CD4+ percent as risk markers for Pneumocystis carinii pneumonia (PCP): implications for primary PCP prophylaxis.
The incidence of Pneumocystis carinii pneumonia (PCP) during 2 years in HIV-infected patients with less than or equal to 100 x 10(6)/l CD4+ cells, less than or equal to 200 x 10(6)/l CD4+ cells and less than 20% CD4+ cells of total T lymphocytes were compared. The relative PCP risk in 57 patients with less than or equal to 100 CD4+ cells was more than twice higher than in 120 patients with less than or equal to 200 CD4+ cells. The latter had almost twice higher relative PCP risk than 271 patients with less than or equal to 20% CD4+ cells. Only 3/56 patients who acquired PCP had greater than 200 CD4+ cells and 15/56 patients had greater than 100 CD4+ cells. Centers for Disease Control (CDC) recommends primary PCP prophylaxis in HIV-infected patients when the number of CD4+ cells is less than 200 x 10(6)/l or when the CD4+ is less than 20. On the basis of the presented data we suggest that primary prophylaxis is considered only when CD4+ cells fall below 200 x 10(6)/l.
Lidman
C
C
Department of Infectious Diseases, Roslagstull Hospital, Stockholm, Sweden.
Berglund
O
O
Tynell
E
E
Lindbäck
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015496:CD4-Positive T-Lymphocytes; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000209:etiology* / Q000517:prevention & control; D011020:Pneumonia, Pneumocystis / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016176:T-Lymphocyte Subsets; D015215:Zidovudine / Q000627:therapeutic use
D015215:Zidovudine