Recent Trends in Pneumocystis carinii Pneumonia as AIDS-Defining Disease in Nine European Countries

Abstract

We analyzed the proportion of AIDS cases with Pneumocystis carinii pneumonia (PCP) at diagnosis among the 43,198 adult AIDS cases diagnosed since January 1988 and reported by June 1992 in Austria, Belgium, France, Germany, Italy, Portugal, Switzerland, United Kingdom, and the city of Amsterdam. In multivariate analysis, the risk of having PCP at AIDS diagnosis decreased slightly with increasing age and was strongly associated with country of diagnosis, transmission category, and year of diagnosis, but not with gender. Since 1989, the proportion of AIDS cases with PCP decreased significantly among homosexual and bisexual men in five of the nine countries examined and among injecting drug users in four of seven countries. In three countries with sufficient data for analysis, no significant decrease was seen among heterosexual patients with a partner originating from a country where heterosexual transmission is common (i.e., Africa/Caribbean). Among other heterosexual patients, a significant decreasing trend was demonstrated in only one of six countries analyzed. For all countries combined, the decrease was significant among hemophiliacs and of borderline significance among transfusion recipients. Results suggest that medical management before AIDS diagnosis is not homogeneous among all human immunodeficiency virus (HIV)-infected persons in Europe. Efforts should be made to provide better information on the potential benefit of early HIV testing and to facilitate the use of preventive treatments.