Saturday, February 25, 2012

The AIDS Alphabet: P is for PCP, PICC Lines and PIs

The AIDS Alphabet: P is for PCP, Pentamidine. PICC Lines and PIs

PCP: Pneumocystis carinii pneumonia (most recent name is pneumonia jiroveci) is a lung infection commonly seen in people with compromised immune system. PCP, otherwise known as AIDS pneumonia, usually occurs in patients with a T cell count below 200. As in the case of CMV (cytomegalovirus), the organism that causes PCP can enter the healthy human body and live peacefully in it for the rest of its life, not causing any damages. Only when the immune system weakens or deteriorates, the organism activates and can cause pneumonia. In the early days of AIDS, PCP was too often a regular cause of AIDS related death for AIDS patients. Medications used for treatment of PCP include: Bactrim, Pentamidine, Mepron (Atovaquone), and Primaquine.

Pentamidine: It is used to prevent and treat PCP usually when the patient becomes allergic to the more commonly used antibiotic, Bactrim. Pentamidine is available in inhalation (for PCP prevention) and injection, or intravenous (for PCP treatment). 

Protease Inhibitors: Protease Inhibitors, or PIs, inhibit replication of HIV protease, which is an enzyme needed for formation and assembly of HIV proteins. An example of PI is indinavir (Crixivan).

PCP, aka pneumocystic carinii pneumonia, pneumonia jiroveci or just AIDS pneumonia, made its presents in the U.S. in a handful of young male individuals who died in a matter of days. PCP was the first sign that AIDS had arrived to the States. As with other AIDS-related opportunistic infections (OIs), the life-extending HAART medications can prevent patients' immune system to weaken to the point where OIs like PCP, KS, CMV can become active. Still, lately it seems that KS and PCP have resurfaced.

AIDS pneumonia, an opportunistic infection associated with a depressed immune system (like in patients with AIDS) has become a focus point and main "character" in photographs, playwrights, books and movies featuring the pandemic. One example is Angels in America, the HBO movie.
Angel in Central Park:Lensbaby Photography, part of the AIDS Museum collection

What it's like to live with (or better said to survive) PCP? Just ask Kurt Weston. He survived three bouts of PCP and is still here to tell the story. And he does, in Journeys Through Darkness--A Biography of AIDS.

Award-winning photographer Kurt Weston's first bout of AIDS pneumonia: excerpt from Journeys third chapter--Dark Angel, named after one of my favorite Kurt Weston images.

As always,  thanks for visiting,
Alina Oswald
Author of Journeys Through Darkness: A Biography of AIDS

with Dark Angel
During his first hospitalization with pneumonia, doctors placed Weston in an isolation ward, which was a common procedure for dealing with AIDS patients, to prevent the disease from being spread, because at the time experts were not sure of all the ways it could be transmitted. When it came to HIV/AIDS, in order to follow hospital rules, both medical professionals and visitors had to go through two separate doors and a ventilation system to enter the patient’s room.
    Kurt Weston woke up hooked to tubes and machines, not sure what was happening to him. He opened his eyes only to realize that people wearing masks, gloves and suits were staring down at him.