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


METHODS
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.
Sáiz Hervas
E
E
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid.
Castilla Castellano
V
V
Miquel Plaza
J
J
Benito Blanco
A M
AM
Martín Llorens
M M
MM
Pastor de Blas
M
M
Izquierdo
P
P
Muñoz Jareño
M A
MA
Sierra
A
A
Nieto
M A
MA
Moreno Collado
A M
AM
Fraguas
C
C
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1; D006801:Humans; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control*; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D015215:Zidovudine
Influencia del tratamiento con zidovudina y de la profilaxis contra Pneumocystis carinii en la historia natural de los enfermos con infección por VIH.