Pneumocystis Carinii Pneumonia (PCP) - Opportunistic Infections

Opportunistic Infections - Pneumocystis Carinii Pneumonia - Cytomegalovirus - Toxoplasmosis - Candidiasis - Cryptosporidiosis - Mycobacterium Avium Complex - Tuberculosis

Opportunistic Infections

Pneumocystis Carinii Pneumonia (known as PCP) is one of the most common AIDS-related illnesses which can develop in up to 85% of people with HIV if they don’t receive preventative treatment.

In the early days of AIDS it used to be one of the biggest killers but now thanks to improved medicines the death rate from the illness has dropped around 30% down to 14%.

PCP is an incredibly serious infection which mainly affects the lungs causing a severe form of pneumonia. It’s rarely seen in people who are not infected with HIV. It has been known to develop in the liver, spleen, lymph nodes and eyes but these cases are extremely unusual.

Caused by a very common fungal organism, Pneumocystis Carinii Pneumonia only attacks people with a very weak immune system.

It generally appears in people when their CD4+ count goes below 200. This is the point at which a person is defined as having full blown AIDS, hence PCP’s reputation as a defining AIDS related illness.

Like everyone who gets pneumonia, whether HIV positive or not, sufferers are likely to experience weight loss, fatigue and general weakness due to the illness.

The initial signs are difficulty in breathing, rasping breath sounds and a very dry irritating cough. Some people may cough up large amounts of phlegm or have pain or tightness in their chest. This is an illness that can kill someone with a very weak immune system so it’s important that patients with these symptoms see their doctor immediately.

Unfortunately for someone with an immune system that is shot to pieces, the likelihood of getting PCP more than once is very high. And after each bout the likelihood of surviving it gets lower - up to 78% of people with HIV survive the first bout of PCP but the figure drops dramatically to 40% if the pneumonia strikes a second time.

And if an HIV positive person smokes, studies have found that they can develop Pneumocystis Carinii Pneumonia three times faster than someone with HIV who doesn’t smoke – basically because not only is the immune system weak but the lungs are being damaged by the effects of smoke as well.

The thing about PCP, though, is that it is preventable – provided of course a person knows they are HIV positive. For some people the diagnosis of PCP is also the first time they hear they are HIV positive or, even worse, that they have full blown AIDS.

Preventing PCP

If a person’s CD4+ count starts to drop towards 300, strong antiviral drugs can prevent it from falling even further which would put the body at risk of developing all sorts of opportunistic infections. If the count goes below 200 there are several medications that can be used to prevent Pneumocystis carinii pneumonia. Bactrim or Septra, a combination of the antibiotics trimethoprim and sulfamethoxazole, are the most commonly used.

Septra, although highly effective in preventing Pneumocystis Carinii Pneumonia , causes and allergic reaction in the form of a rash or fever, in around 50% of people who take it. This can be overcome by gradually introducing the drug into the system.

Other drugs used include dapsone, petamidine and atovaquone – all forms of antibiotic.


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