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1994-10-25
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Document 3090
DOCN M94A3090
TI Opportunistic infections in patients with CD4 counts above 300.
DT 9412
AU Stool E; Piot D; Gathe J Jr; Najjar A; Edwards S; Park Plaza Hospital,
Special Diseases Unit, Houston, Texas.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):156 (abstract no. PB0049). Unique
Identifier : AIDSLINE ICA10/94369485
AB OBJECTIVE: To detail the presentation of opportunistic infection (OI) in
patients with CD4 counts > 300. METHODS: Retrospective review of five
homosexual males, non-IV drug abusers who were followed by the authors
prospectively. RESULTS: Patient 1: 33 yo male HIV positive for 64
months, on AZT for 30 months evaluated for 4 weeks of headaches. CD4
count was 830 prior to admission. MRI brainscan was negative, lumbar
puncture revealed organisms consistent with toxoplasmosis under oil
immersion. Peripheral and CSF toxo titers were positive. The patient
improved on anti-toxo meds and 2 months later his CD4 count was 585.
Patient 2: 48 yo male HIV positive for 20 months and on AZT for 20
months, was admitted with bronchoscopy proven PCP. One week prior his
CD4 was 541, during his illness CD4 count declined to 300 and rebounded
to 520 after recovery. Patient 3: 41 yo male HIV positive for 18 months,
on AZT for 12 months, evaluated for headaches. A lumbar puncture
revealed acute cryptococcal meningitis. CD4 2 weeks prior to diagnosis
was 320. He responded well to therapy, 18 months later CD4 count was
764. Patient 4: 44 yo male HIV positive for 5 years on AZT for 21 months
admitted with bronchoscopy proven PCP. Ten weeks prior to admission CD4
count was 418, responded well to treatment, a week after discharge CD4
count was 403. Patient 5: 41 yo male HIV positive for 2 years on AZT for
two years admitted with bronchoscopy proven PCP and also toxoplasmosis.
Thirty days prior to admission, CD4 count was 370. During
hospitalization CD4 dropped to 279. He responded well to treatment, and
2 months after discharge CD4 was 260. CONCLUSIONS: 1. While OI's are
common in patients with CD4 < 300, we describe 5 patients with OI's and
CD4 counts > 300. 2. Although uncommon, the possibility of opportunistic
pathogens must remain in the differential diagnosis of infections in HIV
patients, independent of absolute CD4 count. 3. This illustrates that
despite laboratory markers, a detailed medical history and clinical
finding are of paramount importance.
DE Adult AIDS-Related Opportunistic Infections/BLOOD/*IMMUNOLOGY Case
Report Human HIV Seropositivity/BLOOD/DRUG THERAPY/*IMMUNOLOGY
Leukocyte Count Male Meningitis, Cryptococcal/*IMMUNOLOGY Pneumonia,
Pneumocystis carinii/*IMMUNOLOGY Toxoplasmosis/*IMMUNOLOGY *T4
Lymphocytes Zidovudine/THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).