Treatment for cerebral toxoplasmosis protects against Pneumocystis carinii pneumonia in patients with AIDS

Article Abstract:

Infection with the human immunodeficiency virus (HIV) inexorably leads to the development of acquired immune deficiency syndrome (AIDS) after a variable latent period. AIDS is characterized by, among other things, recurrent opportunistic infections by a variety of bacterial microorganisms, including the causative agents in an AIDS-related form of pneumonia and toxoplasmosis (Pneumocystis carinii and Toxoplasma gondii, respectively). The commonly accepted treatment for toxoplasmosis, a class of drugs that interfere with folic acid metabolism, operates by the same biochemical mechanism as treatment for P. carinii; hence, it might be expected that AIDS patients undergoing treatment for toxoplasmosis might be expected to show a lower incidence of P. carinii infection than similar groups of patients not undergoing such treatment. To test this hypothesis, a group of 99 patients with cerebral toxoplasmosis (but no previous or simultaneous P. carinii infection) being treated for the condition with pyrimethamine and sulfonamides were compared with a group of 240 AIDS patients with other severe opportunistic infections, and with a group of 113 patients being treated prophylactically (with inhaled pentamidine) against P. carinii infection. Significantly fewer patients being treated for toxoplasmosis developed P. carinii infection than patients who were not receiving such treatment (6 percent versus 21 percent); 6 percent of the patients receiving P. carinii prophylaxis also became infected with the P. carinii microorganism. Hence, the drugs used to treat toxoplasmosis, pyrimethamine and sulfonamides, seem to be as successful at preventing P. carinii infection in AIDS patients as drugs more commonly used primarily to prevent the pneumonia infection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, AIDS (Disease), Toxoplasmosis

---

A controlled study of inhaled pentamidine for primary prevention of Pneumocystis carinii pneumonia

Article Abstract:

Pneumonia resulting from infection with Pneumocystis carinii infection is the most important opportunistic infection in patients with AIDS. Almost half of AIDS patients have died from their first episode of P. carinii pneumonia (PCP), and although improvements in treatment have reduced mortality somewhat, it is clear that any improvements in the reduction of mortality from PCP would be an important contribution to the health of patients with AIDS. Currently, secondary prophylaxis using the antibiotic pentamidine is recommended for AIDS patients, that is, prevention with pentamidine is recommended for those who have already had one episode of PC pneumonia. A study was designed to evaluate the practicality of primary prevention of PCP using pentamidine. A total of 223 AIDS patients who had not yet developed PCP were assigned into either a placebo group or a group receiving prophylactic doses of inhaled pentamidine. Five interim data analyses were planned for the course of the experimental treatment. At the time of the third analysis, it had become clear that the pentamidine treatment was effective in decreasing the likelihood of PCP, and the clinical trail was terminated at that point so that all patients might have the benefits of treatment. During the trial, 23 cases of PC pneumonia occurred among the 109 placebo-treated patients, in contrast with eight cases among the 114 patients receiving pentamidine. The results confirm that pentamidine is effective in the primary prevention of Pneumocystis carinii pneumonia. However, the authors emphasize that the drug is expensive and not completely effective. Therefore, efforts to develop new treatments for this dangerous opportunistic infection must continue. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diseases, AIDS patients, Pneumocystis carinii, Pentamidine isethionate, Pentamidine

---

Dicontinuation of primary prophylaxis against Pneumocystis carinii pneumonia in HIV-1-infected adults treated with combination antiretroviral therapy

Article Abstract:

It appears to be safe to stop giving HIV patients drugs to prevent Pneumocystis carinii pneumonia (PCP) if they respond to antiretroviral drugs used to treat HIV infection. Researchers stopped preventive treatment for PCP in 262 patients who responded to combination antiretroviral therapy for HIV infection. Most had increased their CD4 counts to 200 and almost half had antibodies to Toxoplasma, indicating that they had been exposed to this organism. However, only nine patients had to start taking preventive PCP treatment again. None of the patients developed PCP or toxoplasmosis.

HIV infection, HIV infections, Drug therapy, Combination, Combination drug therapy

Similar abstracts:

• Abstracts: Aerosolized pentamidine for prophylaxis against Pneumocystis carinii pneumonia: the San Francisco Community Prophylaxis Trial
• Abstracts: Aerosol pentamidine for secondary prophylaxis of AIDS-related Pneumocystis carinii pneumonia: a randomized, placebo-controlled study
• Abstracts: Extrapulmonary Pneumocystis carinii infection in AIDS: CT findings. Observations on the growth of renal neoplasms
• Abstracts: Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis in patients with AIDS. The use of corticosteroids in Pneumocystis carinii pneumonia
• Abstracts: Acute pancreatitis: value of CT in establishing prognosis. Extrapulmonary Pneumocystis carinii infection in AIDS: CT findings

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.