Neutropenia and latrogenic Neutrophil Dysfunction in Human Immunodeficiency Virus Infection and Acquired Immunodeficiency Syndrome

Abstract

We appreciate the comments of Arnott and colleagues. We would like to point out that the controlled trial of Hardy et al 1 did show a statistically significant decrease not only in the log rank statistic comparing time with development of bacterial infection, but also in the frequency of infection (19 of 154 patients receiving trimethoprimsulfamethoxazole vs 38 of 156 patients receiving aerosol pentamidine; Fisher exact test, P=. 005). Therefore, we believe that it was appropriate to adjust for the use of trimethoprim-sulfamethoxazole in adult HIV-infected patients. In regard to use of pentamidine in our patients, there was no appreciable use of intravenous pentamidine during the relevant period in cases and controls. There was use of aerosol pentamidine for prophylaxis of P carinii pneumonia in some patients, but it is probably less likely that the inhaled form of the drug would be a confounding variable for bacterial pneumonia, particularly since