Determinants of Short- and Long-term Outcome in Patients With Respiratory Failure Caused by AIDS-Related Pneumocystis carinii Pneumonia

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Abstract
DESPITE ADVANCES in antiretroviral therapy and improved prophylaxis, Pneumocystis carinii pneumonia (PCP) remains a frequent life-threatening opportunistic infection complicating human immunodeficiency virus infection and the acquired immunodeficiency syndrome (AIDS).1-5 Indeed, despite a recent decline in AIDS incidence, the rate of human immunodeficiency virus infection is increasing,6 and PCP remains the most common AIDS-defining illness.7 Acute respiratory failure (ARF) complicates PCP in 5% to 30% of cases,8,9 usually requiring admission to the intensive care unit (ICU).10-12 Because ARF in the setting of AIDS-related PCP has been reported frequently to have a poor prognosis and high in-hospital mortality,3,13,14 many have questioned the appropriateness of offering ICU care to these patients and have attempted to identify prognostic factors predictive of mortality.3,13,15,16 Although physiologic scores have been validated as predictive of in-hospital mortality,17 the clinical utility of such tools in assisting decision making is unclear.