Document 0254
 DOCN  M95B0254
 TI    Patterns of care for and outcomes of Pneumocystis carinii pneumonia
       among persons with transfusion-acquired AIDS.
 DT    9511
 AU    Bennett CL; Horner RD; Aboulafia D; Weinstein RA; Division of Health
       Services Research, Lakeside Veterans; Administration Hospital, USA.
 SO    Transfusion. 1995 Aug;35(8):674-8. Unique Identifier : AIDSLINE
       MED/95357899
 AB    BACKGROUND: The most common human immunodeficiency virus (HIV)-related
       cause of death in persons with transfusion-acquired (TA) AIDS has been
       Pneumocystis carinii pneumonia (PCP). While better treatment for PCP
       accounts for improved survival among HIV-infected homosexual or bisexual
       men, the extent to which others have benefitted from these developments
       is unknown. STUDY DESIGN AND METHODS: Patterns of PCP care among persons
       with TA-AIDS, intravenous drug users, and homosexual or bisexual men are
       compared. RESULTS: TA-AIDS patients were older (mean, 46 years vs. < 40
       for others, p < 0.05), more severely ill (59% had an alveolar-arterial
       oxygen gradient > 48.5 torr vs. 41% of others, p < 0.05), and less
       likely to have received PCP prophylaxis (16% of TA-AIDS patients versus
       24-41% of others, p < 0.05). PCP care and outcomes also differed:
       TA-AIDS patients were less than half as likely to have early use of PCP
       medications (relative odds ratio = 0.45; 95% CI, 70% vs. > 80% for
       others, p < 0.05), more likely to be intubated (22% vs. 9-13% of others,
       p < 0.05), and more likely to die in-hospital (26% vs. 13-22% of others,
       p < 0.05). After controlling for differences in severity of illness,
       insurance, age, and hospital characteristics, TA-AIDS patients were 45
       percent as likely to have early PCP therapy (95% CI, 22%, 91%) as were
       persons in high-risk groups. CONCLUSION: For persons whose only risk
       factor was transfusion, recognition of the HIV infection and its
       complications appears to be problematic, which may help explain poorer
       outcomes in persons with HIV-related PCP.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/THERAPY  Adult
       Bisexuality  Blood Transfusion/*ADVERSE EFFECTS  Female  Homosexuality
       Human  Male  Middle Age  Multivariate Analysis  Pneumonia, Pneumocystis
       carinii/*THERAPY  Racial Stocks  Regression Analysis  Sex Factors
       Substance Abuse  Support, U.S. Gov't, Non-P.H.S.  Support, U.S. Gov't,
       P.H.S.  Time Factors  JOURNAL ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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