Bacillary Angiomatosis and Bacillary Peliosis in Patients Infected with Human Immunodeficiency Virus: Clinical Characteristics in a Case-Control Study

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Abstract
Clinical characteristics associated with bacillary angiomatosis and bacillary peliosis (BAP) in patients with human immunodeficiency virus (HIV) infection were evaluated in a case-control study; 42 case-patients and 84 controls were matched by clinical care institution. Case-patients presented with fever (temperature, >37.8°C; 93%), a median CD4 lymphocyte count of 21/mm3 , cutaneous or subcutaneous vascular lesions (55%), lymphadenopathy (21%), and/or abdominal symptoms (24%). Many case-patients experienced long delays between medical evaluation and diagnosis of BAP (median, 4 weeks; range, 1 day to 24 months). Case-patients were more likely than controls to have fever, lymphadenopathy, hepatomegaly, splenomegaly, a low CD4 lymphocyte count, anemia, or an elevated serum level of alkaline phosphatase (AP) (P < .001). In multivariate analysis, a CD4 lymphocyte count of 3 (matched odds ratio [OR], 9.9; P < .09), anemia reflected by a hematocrit value of P < .04), and an elevated AP level of ⩾2.6 µkat/L (OR, 23.9; P < .05) remained associated with disease after therapy with zidovudine was controUed for. BAP should be considered an AIDS-defining opportunistic infection and should be included in the differential diagnosis for febrile, HIV-infected patients with cutaneous or osteolytic lesions, lymphadenopathy, abdominal symptoms, anemia, or an elevated serum level of AP.

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