Kaplan J E, Hanson D L, Navin T R, Jones J L
Division of HIV/AIDS Prevention-Surveillance and Epidemiology, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Infect Dis. 1998 Oct;178(4):1126-32. doi: 10.1086/515658.
Risk factors for the development of a first episode of Pneumocystis carinii pneumonia (PCP) were investigated in the Adult and Adolescent Spectrum of Disease Project, a medical record review study involving longitudinal follow-up of human immunodeficiency virus-infected adults in 9 US cities. Risk factors included decreasing CD4 lymphocyte count and history of AIDS-defining illness, non-P. carinii pneumonia, oral thrush, or unexplained fever for > or = 2 days; PCP prophylaxis was protective. PCP incidence/100 person-years of observation among persons not prescribed PCP prophylaxis was higher in those with CD4 lymphocyte counts < 250 cells/microL or CD4 cell percent < 14% (8.3; 95% confidence interval [CI], 7.7-9.0) than in persons with CD4 cell counts < 200 or history of thrush or fever, which constitute current criteria for prophylaxis against PCP (5.9; 95% CI, 5.5-6.4). Because of increased efficiency in capturing persons at highest risk, CD4 cell count < 250 or CD4 cell percent < 14% should be considered as criteria for prophylaxis against first episodes of PCP.
在成人及青少年疾病谱项目中，对卡氏肺孢子虫肺炎（PCP）首发的危险因素进行了调查。该项目是一项病历回顾研究，涉及对美国9个城市感染人类免疫缺陷病毒的成年人进行纵向随访。危险因素包括CD4淋巴细胞计数下降以及艾滋病界定疾病史、非卡氏肺孢子虫肺炎、鹅口疮或不明原因发热≥2天；PCP预防具有保护作用。在未接受PCP预防的人群中，CD4淋巴细胞计数<250个/微升或CD4细胞百分比<14%的人群中PCP发病率/100人年观察期（8.3；95%置信区间[CI]，7.7 - 9.0）高于CD4细胞计数<200或有鹅口疮或发热史的人群，后者构成当前PCP预防标准（5.9；95%CI，5.5 - 6.4）。由于在捕捉高危人群方面效率提高，CD4细胞计数<250或CD4细胞百分比<14%应被视为预防PCP首发的标准。
