Survival of patients with AIDS, after diagnosis of Pneumocystis carinii pneumonia, in the United States

To examine survival after diagnosis of Pneumocystis carinii pneumonia (PCP) and factors associated with early death (during the month of or the month after diagnosis of PCP), data were analyzed from the Adult and Adolescent Spectrum HIV Disease project. Among 4412 patients with 5222 episodes of PCP during follow-up (1992-1998), survival at >1 month after diagnosis was 82%, and survival at greater than or equal to 12 months after diagnosis was 47%; 12-month survival increased from 40% in 1992-1993 to 63% in 1996-1998. By multiple logistic regression analysis, early death was associated with history of PCP (odds ratio [OR], 1.4), age 45-59 years (OR, 1.9) or greater than or equal to 60 years (OR, 3.7), and CD4 cell count of 0-24 cells/muL (less than or equal to5 months before PCP; OR, 1.8) or 25-49 cells/muL (OR, 1.4) (P < .05). Concurrent prescription of combination an tiretroviral therapy (OR, 0.2) and other antiretroviral therapy (OR, 0.4) was associated with surviving the early period. This study shows improved survival after diagnosis of PCP in recent years, despite emergence of antibiotic-resistant mutant P. carinii strains.