       Document 0521
 DOCN  M9640521
 TI    Steroids do not enhance the risk of developing tuberculosis or other
       AIDS-related diseases in HIV-infected patients treated for Pneumocystis
       carinii pneumonia.
 DT    9604
 AU    Martos A; Podzamczer D; Martinez-Lacasa J; Rufi G; Santin M; Gudiol F;
       Infectious Disease Service, Ciutat Sanitaria de Bellvitge,; University
       of Barcelona, Spain.
 SO    AIDS. 1995 Sep;9(9):1037-41. Unique Identifier : AIDSLINE MED/96085718
 AB    OBJECTIVE: To evaluate the risk of developing tuberculosis or other
       AIDS-related diseases (ARD) in HIV-infected patients treated with
       corticosteroids as adjunctive therapy for Pneumocystis carinii pneumonia
       (PCP). DESIGN: Retrospective study. SETTING: Infectious Disease Service
       of a 1000-bed university teaching hospital in Barcelona, Spain.
       PATIENTS: HIV-infected patients diagnosed with PCP from 1985 to 1992.
       Patients were classified into two groups: steroid (group A) and
       non-steroid (group B) adjunctive therapy. Baseline characteristics,
       antibiotherapy, dose and duration of steroidal treatment were analysed.
       Endpoints were either the development of tuberculosis or other ARD or
       death. RESULTS: From the 129 patients included in this study 72 were in
       group A and 57 in group B. No differences between groups were observed
       in baseline characteristics or mean follow-up period (15 versus 14
       months, respectively). The mean total dose of steroids was 420 mg
       (range, 160-1260 mg) methylprednisolone or its equivalent in
       dexamethasone, with a mean treatment duration of 12 days (range, 4-33
       days). No differences were found in the occurrence of tuberculosis or
       other endpoints in the first 6 months of follow-up. In addition, the
       cumulative rate of developing tuberculosis was 7% in group A and 12% in
       group B at 12 months of follow-up, and 13 versus 12% at 24 months (P =
       0.622, Mantel-Cox): 4 versus 4% at 12 months and 27 versus 24% at 24
       months (P = 0.873) for non-tuberculosis mycobacterial infection, and 40
       versus 42% at 12 months, and 88 versus 66% at 24 months (P = 0.330) for
       non-mycobacterial ARD. The cumulative survival rate was 79 versus 71%
       and 46 versus 34% at 12 and 24 months, respectively (P = 0.526).
       CONCLUSIONS: Our data suggest that the use of corticosteroids during PCP
       in HIV-infected patients at the doses and for the duration used in our
       patients did not enhance the risk of developing or relapsing
       tuberculosis or other ARD.
 DE    Adrenal Cortex Hormones/ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS  Adult
       AIDS-Related Opportunistic Infections/*DRUG THERAPY/IMMUNOLOGY/
       MORTALITY  Comparative Study  Dexamethasone/ADMINISTRATION &
       DOSAGE/ADVERSE EFFECTS  Drug Therapy, Combination  Female  Follow-Up
       Studies  Human  Male  Methylprednisolone/ADMINISTRATION & DOSAGE/ADVERSE
       EFFECTS  Middle Age  Pentamidine/ADMINISTRATION & DOSAGE/ADVERSE EFFECTS
       Pneumonia, Pneumocystis carinii/*DRUG THERAPY/IMMUNOLOGY/  MORTALITY
       Retrospective Studies  Risk Factors  Survival Rate
       Trimethoprim-Sulfamethoxazole Combination/ADMINISTRATION & DOSAGE/
       ADVERSE EFFECTS  Tuberculosis, Pulmonary/*IMMUNOLOGY/MORTALITY  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

