Geographic Distribution of Human Immunodeficiency Virus-associated Pneumocystis carinii Pneumonia in San Francisco
- 1 November 2000
- journal article
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 162 (5), 1622-1626
- https://doi.org/10.1164/ajrccm.162.5.2002065
Abstract
The epidemiology of Pneumocystis carinii pneumonia (PCP) and its geographic distribution are incompletely understood. We examined the influence of geographic location as a risk factor for PCP through a retrospective case-control study of HIV-infected persons evaluated for PCP at San Francisco General Hospital. Subjects had microscopically confirmed PCP diagnosed between January 1996 and June 1999. Control subjects had a presentation suggestive of PCP, but had bronchoalveolar lavage examination that did not reveal P. carinii. Medical chart review was performed to obtain demographic and clinical characteristics of the subjects as well as their addresses at time of PCP evaluation. Multivariate analyses were performed in order to identify variables associated with PCP. Lack of P. carinii prophylaxis and a CD4 cell count </= 50 cells/microl were independent predictors of an increased risk of PCP. Interestingly, subjects living in the 94103 zip code had a significantly lower risk of PCP than subjects in other areas (odds ratio = 0.2, 95% confidence interval 0.1-0.6, p < 0.01). This effect was present despite controlling for risk factors for PCP such as use of prophylaxis or antiretroviral therapy, CD4 cell count, and HIV RNA level. We conclude that residence in the 94103 zip code of San Francisco is associated with a substantially lower risk of PCP than residence in other areas of the city.Keywords
This publication has 18 references indexed in Scilit:
- Genetic Variation in Pneumocystis carinii Isolates from Different Geographic Regions: Implications for TransmissionEmerging Infectious Diseases, 2000
- Risk Factors for Community‐Acquired Pneumonia among Persons Infected with Human Immunodeficiency VirusThe Journal of Infectious Diseases, 2000
- Tuberculosis in the Inner City: Impact of a Continuing Epidemic in the 1990sClinical Infectious Diseases, 1999
- Bacterial Pneumonia in Persons Infected with the Human Immunodeficiency VirusNew England Journal of Medicine, 1995
- Coccidioidomycosis among Visitors to a Coccidioides immitis-Endemic Area: An Outbreak in a Military Reserve UnitThe Journal of Infectious Diseases, 1995
- The Epidemiology of Tuberculosis in San Francisco -- A Population-Based Study Using Conventional and Molecular MethodsNew England Journal of Medicine, 1994
- The development of Pneumocystis carinii pneumonia in germ-free rats requires immunosuppression and exposure to the Pneumocystis carinii organismComparative Immunology, Microbiology and Infectious Diseases, 1993
- Epidemiology of Blastomycosis in a Region of High Endemicity in North Central WisconsinClinical Infectious Diseases, 1992
- Possible transfer of Pneumocystis carinii between kidney transplant recipientsThe Lancet, 1990
- Serologic Responses to Pneumocystis carinii Antigens in Health and DiseaseThe Journal of Infectious Diseases, 1990