Epidemiologic Patterns of Upper Respiratory Illness andPneumocystis cariniiPneumonia in Homosexual Men

Abstract

The relationship between self-reported upper respiratory illness symptoms (URI) and human immunodeficiency virus Type 1 (HIV-1) was examined in homosexual men using semiannual visits from 1984 to 1988. Temporal and geographic patterns of Pneumocystis carinii pneumonia (PCP) diagnosis in these men during the same time period are also described. URI, including acute sinusitis, was reported more often by 916 HIV-1-seropositive participants than by 2,161 seronegative participants (32.21 versus 28.86% p less than 0.001). For 387 seropositive subjects who progressed to acquired immunodeficiency syndrome (AIDS), the proportion reporting URI peaked one visit pre-AIDS at a level significantly higher than matched control subjects (0.45 versus 0.28, p less than or equal to 0.001). The peak was higher for those with PCP as an initial diagnosis. Reported URI peaked in winter and troughed in summer, and PCP diagnosis rates peaked and troughed 4 months later, respectively. Cities with the highest reported rates of URI also had the highest proportions of AIDS cases with PCP as an initial diagnosis. No temporal or geographic patterns were observed for other HIV-1-related symptoms or non-PCP AIDS diagnoses. These patterns suggest the possibility of a person-to-person transmission of P. carinii similar to that of other respiratory pathogens, which would imply a need to consider stricter methods to prevent nosocomial transmission of this pathogen in inpatient and outpatient settings. Further investigation of these issues is needed.

Influence of Climatic Factors on Pneumocys Carriage within a Socially Organized Group of Immunocompetent Macaques (Macaca fascicularis)

“…In a large retrospective study about AIDS‐defining diseases in European countries, Delmas et al [3] indicated that the risk of pneumocystosis in UK was more than twice as high as that in Portugal. Similar observations were made according to the climate of cities in the USA [6]. Only one study reported a correlation between low rainfall and new cases of pneumocystosis [8].…”

Factors Associated with the Development of Pneumocystis carinii Pneumonia

“…They noted a higher incidence of PCP in AIDS patients from northern regions, as did another recent study from Europe [2]; similar findings were reported by the American Multicenter AIDS Cohort Study (MACS) with regard to AIDS patients before the availability of prophylaxis from 1986 to 1988 [3]. In our analysis, cohorts of AIDS patients with the highest rates of PCP also had the highest incidence of upper respiratory tract infections [3].…”

Long‐Term Serologic Responses to thePneumocystis jiroveciiMajor Surface Glycoprotein in HIV‐Positive Individuals With and WithoutP. jiroveciiInfection

“…and K.R.D., unpublished data). Even though seasonal differences in antibody levels were not found, climatic factors, such as temperature and humidity, have been shown to influence the occurrence of PCP [29 –32] and might have had an effect here.…”