EQUAL SURVIVAL RATES FOR 1ST, 2ND, AND 3RD EPISODES OF PNEUMOCYSTIS-CARINII PNEUMONIA IN PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Background.-Second and subsequent episodes of acute Pneumocystis carinii pneumonia (PCP) are reported to have a worse prognosis than initial episodes in patients with the acquired immunodeficiency syndrome. We tested the hypothesis that survival rates of first, second, and subsequent episodes of acute PCP in patients with the acquired immunodeficiency syndrome are equal. Methods.-Analysis of the outcomes in prospective series of patients with the acquired immunodeficiency syndrome treated for acute PCP over 5 years. Results.-Survival rates of 222 PCP occurrences by episode number were: first, 86%; second, 84%; third, 88%; and fourth, 67%. Survival rates for the first, second, and third episodes we're not significantly different. Second and third episodes had a larger proportion of patients with mild disease than initial episodes. Conclusions.-Survival rates for first, second, and third episodes of PCP in patients with the acquired immunodeficiency syndrome are not different. In contrast to earlier articles, treatment for second and third episodes of acute PCP may be as successful as in initial episodes.