Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Tu.B.2299 - Tu.B.2304

Tuesday July 9, 1996

Conclusions: Int99 )1-1 Ii 3 rpriP de otetrmicc the 0 3 ofPAPH 431 n ir ole
o u e I i t r to 11ittic ii i ii repeirtriule were cic Ifor full
pt()e'H

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t H s 31:(H?09!Olt,Seitze iand.

Tu.B.2299
NEUTREXIN (TRIMETREXATE GLUCURONATE) AS AN EFFECTIVE AGENT IN THE
TREATMENT OF PNEUMOCYSTIS CARINII CHOROIDITIS:A CASE REPORT
""il. Wisn P 1Fartrtt D,1 3 Ic VVHrh 3 bN. 'RytlFee HoiptalSchool e
Med ici odon U.K., UB Ph rrLtd rl 1oy reen, tI.lad.K
Objective: Neittevi sap i,)ent 3 3 1 oP;; -i uthydt 3 tiie reduc lie ird hit been
shown tbeof berefit iit(ii teeveui of ~it ~royr itt rnnpreumonia. (PCP).Iha
shw i i 3in ativily iIir oth iii ~tiP patientiard1thoe itolerataii icfractotry to
ihe ftr,'tiintctrerti ' trell pr 'up3 1143 xaitti TMPtSMP. W've present
iee t efrsiit c rpot in HIi 3V p ~ive p tieii Ncric evedieaicxtin to treat pv
r ft Ii PC). irr
Methods: iie pliri twrt Ilis r ci trnic tel iristit-esentdviiwitnADS defnn
inesin erihe 199tt i t ii iC C)-t crv ~iretrop I e 3ofPCP chionic hepatitis
B, chroicrptr ciii iii d3oI Lbtri vet za is detc.Ptenti ii tettedfoi PCOP
wiviTMP/SMX, peiiri din-,id c 3 beiuentti eeivit riphylax iorPCPtnameiy
perit iti c3 I o i:r.dr p i 01) f!cr.upJvt st inJair.1935)1thcptint htd
ncrnticyc hsoy ittiv131 It av i: u tv-1rr 33 heye 131 tr6iutiMty 1995 whenithe
paticrt experecdrt.c C 31 i.ii Dfctiii c- ird wr 0 tumpinith13eri ght eye.)lhe
ophthalmi c rc- t pti ' I',r itt I I ' irr i cc wast6/63 hind sc pp it
rhe fit ii )1 (fioyr 3 ft.-' ii c- t c iv l~ m>tld ippetranc f the mcula. The
optici, c,blodc iciicii ciadpe 1/ r tor ore 2 cand3ivwerenrmInlthe!effieye t3e
fttrdii p,v.^it tfud~. i:t? piy i c ld l i iunrscrcelo sigyhtlyelevated
chotitri c s~ r 131 1i(_i f Pti. i sif PC i di swasrrtdcon the
ass( prtiltvi vctrt,)w.No _) r vi,tonrwr idetfed inthe lung ith the

eyephe ony13r<3incf33 ia i viv vrtttitoepitieit starteilcxi tratmrt in
Nay 19> iat 't y. ii n2IV dily t 3 283 aysitt occliy f3 1 1 rid V. r-oi ecuccc it
2npvm2,eveni p~fhr alit
Resulcs: F iert copletIc'heinp inI a e 13) witr I ceiou itde cffectsvto ncctrcxir.
Or Septenber ct 5 }t h WI1 ihi' Pt 1 3 1t'ind v d photogrphtp3prevealed thit the yelConclusions: TPhis c e1 i le d m ntr ht Ii c i i' e.3 cvi rwas1h3ghly ffectiye in ir-c ticp
PC C203 t 33i r ti(cciitih AIDS i i tier i-cthe tvhotet ei treteti
etra pulmit n tiy n ifetalt ion w ith 3 t t (Ii 1 lfii
O i, USS3P3 iii iLtd, Sit ' & 12 (3ei( 113r11)r3.. Ccc Pt ccsnesPark rvvey
Gric er lcis VVOIhYh3F, Frpglrn.323 hel3t1 923 2083107
Tu.B.2300
RISK FACTORS FOR DEATH FROM PNEUMOCYSTIS CARINII PNEUMONIA IN THE
UNITED STATES
PreventonAtititiP A
Objective: Toc eve figaert f<ictorsfo eit iiifrit P Cei 31.11 airripncuirat(tPCP)
amon ocHIV infectedI pcion nIe tU.iS.
Methods: YTe Aduit Spc ' i of30Dic Sud1 ice yoeri3 00HIV-nfected tdults
3 yetis 3fiae I in 1 c i IcntheU.S. ii 3 fuo i co;Pr eticalricordi tie reveied a3
PCP betwee Jan 19)0 and Hec 934,feath fiom P3CP wi defined at deith in e scmc
mionthias PCfdtagnoi vd n lusiof P idethidipgoi it skIPfators foPCP
detthf(C)43+ cunarire citac3. V ii p rufwec ascsscdbyplogicic gesor
Results: 03 280) subets 1 i cc) dwithPHIP 22 (8.0()died fto PCP ittluding
1 4175(72%)cmen3 3hticave o ithi mentanit /13 3 in3jcticg drug usciv
(IOU rrCoptrcdit thoif cii (D4t cont3- > 3 el3/iv ihi3 rothsvof PCP
dtcrosi, sbets ithino C4+3~ ir,icemntrcoided wee it itceasedttvsk(OR=14
p=.02),ird t33sc ivif 1C0-+ 530vwctc it decrciscdis3(RPP:,19,p.00 c f deith.
Ps kwat aitsoceitilage, pcrdcr; rcIr-HIVi skp u,tn,IiDOUceemote likely
thathe idHIV risk ccoip-, ti erno 01~+ ionti-crce itin'6 cnths cf PP
dignosis OR= 14, p=2.003
Conclusions: Rtsk of det fromr PCP ii ncsdincpaticci with thc lowet32034+cunts
the incretvcd risk in patientswith n re cint LD3+ cr3ntrecodddmap, reflect scopticc
medicire pioito diyris
Joaha8. Ktplai, eters0for- D iseas ' t d PreventinMS-G.-29, Atlan~ta, GA,
tel [phone], Stx: (30)8)9-2007enail:.jck2(o idhiviercdc.gcv
Tu.B.230 I
A PATIENT FRIENDLY REGIMEN OF TMP/SMX DESENSITIZATION
Ward, [ouglas. Pric, PA. Wahinp3tD.C.H3US.A
Issues: Preum cyvtir pnevulocit. 3crrlciy (hemo3tcmn1oportuitcc 3cinfection assi
cteid wit3 AIDS, car be effectivy ep vcrnlcd with prophylac3tii iniethopitm w famexazole (TMP/SMX)
Project: In the rcent past m3ip lepegc ie haivc been deccibed f3r1 devensitizing paitenis
to IMP/SMX. Mary o3 thesecrecpmccc are diffc utoperfctm, rcqu irng a plharmaito
prepare the diliocc tcd us inga ying e ovieaccirc the idmicnitvied dove. We dcci be a
more fpatient-ftiendly" regvcciofTMP/SMX desenvittztitoc,using ditons ofTMP/SMX
btsed cvnvicasuring cups rid teaspoons. Pattcciv prepare the diluttons themselvesvubsiantial peduincg thc covt o3 the ireatmccnt.
Results: We have attempiee)niccztionof thirt- patents with thys p103tcl21 70%
wete-c cccsfIclydesensiizcd v e beer altb coccitiue n ITMP/SMX proprylaxis.
Lessons Learned: A n Iiv 33 131rof paient w 3 yae had aIleci pccti ons to TMP/SMX can
be dcsccitzedui a cnetie t ccimpvfvin3creict conietirhtions ofithe drip mixed
at fome wth smple mcccingfievics
DouglasJ. Wtrd,.MMD. 7)7 20th Strecci.NW. Washington,3)D.. 202)-715-0201

Tu.B.2302
PRESCRIPTIONS FOR Pneumocystis carinii PNEUMONIA (PCP) PROPHYLAXIS
AMONG PATIENTS IN HOSPITAL-BASED HIV CLINICS IN NEW YORK CITY (NYC).
udith St koff '. McFarlind J 12,Vt1) i rvf 3 - Pt 3E.n-r tic c
the NYC ASH Consortium. NYCt Orit let'I tt3it;fU;32. EfceeHospial Meca CtHentci. NY NY
Objective: To deicitbe orescription phutrnsrvfor PCP p- p3. cc.;; nI tic I rr. c 3
counts<aOO clsv uP tit hvpital-based HIV!cliis I NYC
Methods: TheAdultSpectrun of HIV Diseetu33.a111.3 - orituila tud t f i
infecied31 titentv.Ihtv anatlysts diraws npatients atfi ve HIVs - -s f NY,i 99 31) 9(
were revewed at sx-monthtintervals.A cohortnofI!,01rpaie- s ith D4 iri 20P
preycribed prophyltxis.
Results: 1)3 (he 1,032 pateni.. 72% evaei c 1f 3>,Aft it-i 1 a-,'('3)'-H sacv
Thecmedman agewasc39 (rtrccv2071. 5 wrcc ctcing;vet t J1f2 6 v
had cex vith men 3MSM) ind 9 haid highi riskhterisexual p i- iHP}.
(77~,))paients wrcprescrbcd dtrgfor POP3pr sp i. 3, c' hcr I cti)'rltve (-D,4
cunt wiv documncted belom 20f0clsuP. Thieprclc ' - 31 - 11
HIV ciskexpositre -chiegoric p= -37). 673 1780i lpai ct I.i I 1,olvi ii fog
vmorintervalsofnhcthes/61paits,.211 (44~%,werc3e I Ir ' 3i; rphy iv I I,ii
qceci intas.there mere n11signuifin dfferecescamtng pD("'),34 313 - 1 331 Thcip
pornpreycribed pir1p3ylaxis c in,il:p=I'll f. 3..3cried prophyaxis ccintiuocsl, 2)U 77 t had no ci - I c- t, in,r!rt i -
htospialduict one or mote intctvaiti
Conclusion: The majoicy ofypaits t iv 3 13 r3 - c i tt
drugp for PCP prophp'tvisatrthe-ir, p r -tnil. cc-i--. r
scribed p-ophipliv withcutcci orrpt 1 1333 tlc ' i~lRe,,,c cI c c
pattentcsrdo not rccainron prophp-ais, ict ci drp l t oI vc
Jutdih St 3 of NYC Departmentiof3Heirr 1346 B PrayP.-3- N"tcYo I
Icl: (22.4312 Fax: (212L 495 7
Tu.B.2303
PNEUMOCYSTIS CARINII PNEUMONIA (PCP) PROPHYLAXIS AND PCP IN
ADVANCED HIV DISEASE: IMPACT OF PROVIDER HIV-SPECIFIC SERVICES
ITnerBarbara I., MarksonLbf. ci f.CrosiPr-L30 Ik:ViA! ti- rf11,.) I
Philadelpia, PA. USA, and -NewcYirk State (NYS P i pc --rt- 9 1i.
NYPUSA.
Objective: Preveior of Prit I ~sit ccni peui-a c F 3 ~od tc i t,I Icic
sor wit advnced HIV disasct!ot esliii 13. 331 ixi lhvi ii tilt. 1,: r~if
We cirail ned (he asiocratirnchinic I 3313 vic seviiciii 1wit cifdd3 r IId.. r - 3
HV paietscteted inthese ciicstdPP p it - ilt 31 ipc~c t, ec cc F ii
PCP
MtosDietrof15cicssvigathusasurerraet fcY Sri(NYS) Meii d enrolles ih AID)S ivrrcirvicwd rcvi i ' - c.ctvc-'
dhta werc-ircked for anali Iodccco1rapicci Ii' ttan p,ii-it 'r.' '1ciii it t ii_
Mcdcttd HIV/AIDSie fhr inivdsdia)gnocdvwiih A[)S in )9-2PArl r,r
prophylais piecrbed in the sxc.onill beforc AIDP a icr rs i.3 ( 3 c v1,i
diagnosis were assessed cusing generalizd cci 1113t cp quaio
Results: 2,48 I3in3ct2,248os, 7HIVa infected i,;'1 'pereopeii 97PCP ridhlaxs ws oreliklyforp-tens:i -lnis3cve p..3 r vpetil Ici
(oddsvrato2.60: 95% confidercnctrvat. 35t I.I'5) ap 3 3fo -'1 ti i liv s. t
(odds ai.82: 1.29 to 2.57,01r1ac1111anifi- (d-it -i 3o. i-'
PCP waslsc ikely inpattcintsfoloweiciics viighe, lfr ti I d cc 3. 11333. ti'
cire (odd aito 0.74,395%conicidecrut vli056to Pit9h). hr p1 - I'
monotoncaliy with more HIV-sp Ccit 'vie.c 'd 3 '- ft P'_,
patients iniccicics with (hrec iv mic-secic-s
Conclusions: fris analysts sugestis3t3at ic 3cs fr ingar - i. 'HI-ii i: services tt
be cmore effecttve tn preveniigPPCP ic pienwt er y. 3 v srii c '. '3
BJ Turnccr.Jefferson Medical Ho cpc,025 WtaInciSt. Ste. F A t vi
235)951-8907, fax: [phone]
Tu.B.2304
PNEUMOCYSTIS CARINII PNEUMONIA (PCP) IN IMMUNOCOMPROMISED HOSTSA COMPARATIVE STUDY AMONG PATIENTS WITH AND WITHOUT AIDS
Raychaudhuc,Siba P.,IHurlep LPStu S. Dcpt. 03 Me)dccin, Kitrc iii 1atcre 3) HoptlPti
Aito, HA.,PUSA
Objective:ITo compare the clinimal urce and pipigess ofpti 183cc fhe Iid r<I,
L
0
a

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