Robert S. Klein, MD
To the Editors: Heald and colleagues (1) report a higher pneumonia-free survival among patients with the acquired immunodeficiency syndrome (AIDS) and cerebral toxoplasmosis than among patients with AIDS and other severe opportunistic infections. They conclude that maintenance therapy of the former group with sulfadiazine and pyrimethamine is likely to be effective prophylaxis against Pneumocystis carinii pneumonia. This conclusion is logical, but further comment about its certainty is necessary.
The investigators appropriately discuss the limitations of retrospective comparisons. They note that because the patients in the toxoplasmosis group had lower CD4 cell counts than did those in the other groups, the
Klein RS. Does Cerebral Toxoplasmosis Therapy Protect against Pneumocystitis in AIDS?. Ann Intern Med. ;116:524. doi: 10.7326/0003-4819-116-6-524_1
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Published: Ann Intern Med. 1992;116(6):524.
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