Journal articles: 'AIDS; PCP'

1

Wasser, Larry S., Elliot Brown, and Wilfredo Talavera. "Miliary PCP in AIDS." Chest 96, no. 3 (September 1989): 693–95. http://dx.doi.org/10.1378/chest.96.3.693.

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&NA;. "Desensitisation to PCP prophylaxis in AIDS." Inpharma Weekly &NA;, no. 913 (November 1993): 21. http://dx.doi.org/10.2165/00128413-199309130-00050.

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&NA;. "Desensitisation to PCP prophylaxis in AIDS." Reactions Weekly &NA;, no. 477 (November 1993): 2. http://dx.doi.org/10.2165/00128415-199304770-00004.

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4

&NA;. "New hope for PCP in AIDS." Inpharma Weekly &NA;, no. 817 (December 1991): 5. http://dx.doi.org/10.2165/00128413-199108170-00016.

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Wang, Mengyan, Guanjing Lang, Ying Chen, Caiqin Hu, Yongzheng Guo, Ran Tao, Xiaotian Dong, and Biao Zhu. "A Pilot Study of Echinocandin Combination with Trimethoprim/Sulfamethoxazole and Clindamycin for the Treatment of AIDS Patients with Pneumocystis Pneumonia." Journal of Immunology Research 2019 (December 1, 2019): 1–5. http://dx.doi.org/10.1155/2019/8105075.

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Background and Objectives. Pneumocystis pneumonia (PCP) is a common opportunistic infection in acquired immune deficiency syndrome (AIDS) patients that continues to result in a high mortality rate. To develop a better treatment strategy and improve PCP prognosis, a cohort study was conducted to evaluate the therapeutic potential of echinocandin treatment for AIDS patients with PCP (AIDS-PCP). Methods. The AIDS-PCP patients were analyzed in our retrospective cohort study that were hospitalized in The First Affiliated Hospital of Zhejiang University during 2013–2018. The antifungal effects of echinocandins were evaluated in two subgroups that were classified by oxygenation as a proxy for the disease state: PaO2/FiO2>200 mmHg and PaO2/FiO2≤200 mmHg. Intergroup comparisons and survival curves were used to evaluate the effectiveness of the two AIDS-PCP treatment regimens. Results. During the follow-up, 182 AIDS-PCP patients were diagnosed and analyzed in the study. After excluding 55 patients with other superinfections and five patients that were treated with HAART, the remaining 122 patients were enrolled in the study. The group treated with echinocandins combined with trimethoprim-sulfamethoxazole (TMP-SMZ) and clindamycin exhibited a lower mortality rate (9.62%, 5/52) than did the group with TMP-SMZ and clindamycin treatment (20%, 14/70). For AIDS-PCP patients in the PaO2/FiO2>200 mmHg subgroup, treatment with echinocandins combined with TMP-SMZ and clindamycin significantly reduced their mortality rate (4.44% (2/45) vs. 18.18% (10/55), P=0.035). Conclusion. The results of this study indicate that treatment with echinocandins in combination with the standard TMP-SMZ and clindamycin regimen can improve the prognosis and reduce the mortality rate in patients with mild to moderate AIDS-PCP disease.

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Prasetyo, R. Heru. "PNEUMOCYSTIS PNEUMONIA (PCP) DI PENDERITA HIV DAN AIDS DENGAN KELAINAN PARU." INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY 20, no. 1 (October 16, 2016): 34. http://dx.doi.org/10.24293/ijcpml.v20i1.446.

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PCP is one of the most common opportunistic infection in HIV and AIDS patients. A definitive diagnosis of PCP in HIV and AIDS patients in Dr. Soetomo General Hospital Surabaya has not been previously done. A definitive diagnosis have the role in the therapy and to prevent the illness as well. PCP is diagnosed by using a microscope to indentify Pneumocystis jerovecii in the lung fluid or tisuue. The objective of this study was to know how to detect Pneumocystis jerovecii in the sputum samples and to know the determination of the prevalence of PCP in HIV and AIDS patients suffered with pulmonary symptom who were hospitalized in Dr. Soetomo General Hospital Surabaya. This research was carried out by a cross sectional study utilizing waste sputum samples from HIV and AIDS patients. The detection of Pneumocystis jerovecii used Giemsa stain. Six sputum samples among 18 sputum samples (33.33%) HIV and AIDS patients were Pneumocystis jerovecii positive. Based on this findings HIV and AIDS patients with pulmonary symptoms should be suspect having the possibility of PCP as opportunity infection in HIV and AIDS existed, and there for the detection of the Pneumocystis jerovecii in sputum sample must becoming routinelycarried out in the laboratory examination for HIV and AIDS patients which also suffering pulmonary symptom.

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7

&NA;. "Three regimens compared in AIDS-associated PCP." Inpharma Weekly &NA;, no. 1036 (May 1996): 11. http://dx.doi.org/10.2165/00128413-199610360-00026.

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8

&NA;. "??? while PCP prophylaxis improves survival in AIDS." Inpharma Weekly &NA;, no. 863 (November 1992): 13–14. http://dx.doi.org/10.2165/00128413-199208630-00031.

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9

Block, Brian L., Tejas Mehta, Gabriel M. Ortiz, Sean P. Ferris, Thienkhai H. Vu, Laurence Huang, and Adithya Cattamanchi. "Unusual Radiographic Presentation of Pneumocystis Pneumonia in a Patient with AIDS." Case Reports in Infectious Diseases 2017 (2017): 1–6. http://dx.doi.org/10.1155/2017/3183525.

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Pneumocystis jirovecii pneumonia (PCP) typically presents as an interstitial and alveolar process with ground glass opacities on chest computed tomography (CT). The absence of ground glass opacities on chest CT is thought to have a high negative predictive value for PCP in individuals with AIDS. Here, we report a case of PCP in a man with AIDS who presented to our hospital with subacute shortness of breath and a nonproductive cough. While his chest CT revealed diffuse nodular rather than ground glass opacities, bronchoscopy with bronchoalveolar lavage and transbronchial biopsies confirmed the diagnosis of PCP and did not identify additional pathogens. PCP was not the expected diagnosis based on chest CT, but it otherwise fit well with the patient’s clinical and laboratory presentation. In the era of combination antiretroviral therapy, routine prophylaxis for PCP, and increased use of computed tomography, it may be that PCP will increasingly present with nonclassical chest radiographic patterns. Clinicians should be aware of this presentation when selecting diagnostic and management strategies.

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10

Beck, Eduard J., Sundhiya Mandalia, David L. Miller, and John R. W. Harris. "improving survival of AIDS patients St Mary's Hospital, London, 1982-1991 Hospital service interventions and." International Journal of STD & AIDS 9, no. 5 (May 1, 1998): 280–90. http://dx.doi.org/10.1258/0956462981922214.

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Summary: The relationship between changes in hospital service interventions at St Mary's Hospital, London, reduced case fatality for patients with their first episode of Pneumocystis carinii pneumonia (PCP) and improved survival from diagnosis of AIDS was investigated for the period 1982-1991. Multivariate logistic regression models identified factors independently associated with episode survival; for those patients who survived their first episode of PCP, survival from time of diagnosis of AIDS was analysed using multivariate Cox's proportional hazards models. The case-fatality rate after 1987 was significantly lower for the 159 subjects. Median survival from diagnosis of AIDS increased significantly from 142 days to 554 days ( P =0.01). Improved survival of first episode of PCP was associated with it being the index diagnosis and having a haemoglobin at diagnosis of PCP greater than 12 g/dl. The presence of a concurrent AIDS-defining condition in patients who presented with an A-a gradient equal to or greater than 40 mmHg was associated with reduced episode survival, especially before 1987. For the 126 individuals who survived their first episode of PCP, death rates were lowest in patients treated with primary or secondary PCP prophylaxis and those who received zidovudine since their first episode of PCP. Survival in patients with HIV disease is better in patients who receive appropriate antiretroviral treatment of HIV infection and timely treatment of opportunistic illnesses. Early diagnosis of HIV-1 infection with early diagnosis and treatment of first episode of PCP was associated with improved episode survival. Subsequent medical follow up combined with PCP prophylaxis and zidovudine were significantly associated with long-term survival.

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11

Taeb, Abdalsamih M., Joshua M. Sill, Catherine J. Derber, and Michael H. Hooper. "Nodular granulomatous Pneumocystis jiroveci pneumonia consequent to delayed immune reconstitution inflammatory syndrome." International Journal of STD & AIDS 29, no. 14 (August 16, 2018): 1451–53. http://dx.doi.org/10.1177/0956462418787603.

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Although Pneumocystis jiroveci pneumonia (PCP) is a frequent manifestation of acquired immune deficiency syndrome (AIDS), the granulomatous form is uncommon. Here, we present an unusual case of granulomatous PCP consequent to immune reconstitution inflammatory syndrome (IRIS) after highly active antiretroviral therapy. A 36-year-old woman with human immunodeficiency virus (HIV) presented with cough and dyspnea that were attributed to typical PCP associated with AIDS. She was successfully treated with antibiotic, steroid, and antiretroviral therapies. After six months, however, she presented with consolidating lung lesions caused by bronchial obstruction from PCP granulomatous disease. Although antibiotics were ineffective, the effectiveness of steroid therapy suggested a diagnosis of granulomatous IRIS caused by persistent PCP antigens. Physicians should strongly suspect PCP in HIV-positive patients with nodular lung lesions and must remain aware that these lesions, if immune in origin, might not respond to antimicrobial therapy.

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12

&NA;. "Trimetrexate second-line therapy for AIDS-related PCP?" Inpharma Weekly &NA;, no. 1010 (October 1995): 5. http://dx.doi.org/10.2165/00128413-199510100-00010.

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13

&NA;. "IV gammaglobulin aids recovery in methylprednisolone-induced PCP." Inpharma Weekly &NA;, no. 881 (April 1993): 21–22. http://dx.doi.org/10.2165/00128413-199308810-00053.

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14

&NA;. "Survival benefit in HIV/AIDS with PCP prophylaxis." Inpharma Weekly &NA;, no. 934 (April 1994): 17. http://dx.doi.org/10.2165/00128413-199409340-00033.

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15

Sitanggang, Firman Parulian, and I. Gusti Ayu Mardewi. "Perbandingan Diagnosis Klinis dan Radiologis Pneumocystis Carinii Pneumonia pada Pasien HIV/AIDS di RSUP Sanglah Denpasar." Jurnal Radiologi Indonesia 3, no. 2 (September 9, 2019): 39–43. http://dx.doi.org/10.33748/jradidn.v3i2.64.

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Background: Pneumocystis carinii pneumonia (PCP) is a lung infection caused by fungus Pneumocystis carinii. More than half (70 - 80%) of people with AIDS get at least one episode of PCP on their clinical course, with mortality ranging from 10% to 40%. Usually, there is no abnormality in pulmonary physical examination. Chest radiographic examination is one of the non-invasive examinations to make the diagnosis of PCP. Radiographic examination may find an abnormal picture or normal picture.Purpose: To compare the diagnosis of PCP in HIV/AIDS patients made by clinical versus radiology examination at Sanglah Hospital.Method: Type of this research is descriptive cross sectional study. The number of samples in this study were 51 samples obtained by total sampling technique. Data obtained from secondary data is from medical record.Result: After univariate and bivariate analyze, from 51 samples, 68.8% of the samples were radiologic diagnose with PCP and 76.5% were clinical diagnose with PCP. From bivariate analysis 82.9% were diagnosed PCP radiologically and clinically.Conclusion: Thorax imaging is a good imaging modality in early diagnosis and excludes the differential diagnosis of PCP.

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16

Porter, Kholoud, Christopher K. Fairley, Patrick G. Wall, Barry G. Evans, David J. Goldberg, Melanie Weerasuriya, and Ahilya Noone. "AIDS defining diseases in the UK: the impact of PCP prophylaxis and twelve years of change." International Journal of STD & AIDS 7, no. 4 (July 1, 1996): 252–57. http://dx.doi.org/10.1258/0956462961917924.

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We examined all reports of adult AIDS cases made to the 2 national surveillance centres in the UK for changes in AIDS defining conditions between January 1982 and September 1994. Differences and changes among persons diagnosed since January 1988 who had and had not been aware of their HIV infection prior to their AIDS diagnosis were of particular interest. Pneumocystis carinii pneumonia (PCP) is the AIDS defining disease most often reported at the initial AIDS diagnosis. Its proportion of all AIDS cases has increased significantly between January 1982 and December 1987 and decreased markedly thereafter. Since January 1988 a significant decrease in the proportion of cases diagnosed with cryptosporidial infection was also observed while increases were observed in the proportion of cases diagnosed with: HIV wasting (chi21=5.56), PML (chi21=19.47), mycobacterium avium complex (chi21=35.76) and pulmonary tuberculosis (chi21=144.0). For cases diagnosed between January 1988 and September 1994, PCP was more likely to be diagnosed in patients previously unaware of their HIV infection (P < 0.01) as was extrapulmonary TB (P < 0.01). In contrast, the following diseases were more likely to be diagnosed in patients already aware of their HIV infection prior to the diagnosis of AIDS: oesophageal candidiasis (P < 0.001), HIV wasting (P =0.07), mycobacterium avium complex ( P =0.0001), cytomegalovirus disease (P < 0.001), HIV encephalopathy (P =0.0009) and cryptosporidial infection (P =0.02). Prophylaxis and anti-retroviral therapy appear to have had a significant impact on the temporal changes of the most frequently diagnosed AIDS diseases. While PCP prophylaxis has substantially reduced the likelihood of a PCP diagnosis at AIDS, the corresponding increase in other opportunistic infections suggests that there may be a need for improved prophylaxis for these conditions.

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17

Wu, Liang, Zhe Zhang, Yu Wang, Yiwei Hao, Fang Wang, Guiju Gao, Di Yang, Jiang Xiao, and Hongxin Zhao. "A Model to Predict In-Hospital Mortality in HIV/AIDS Patients with Pneumocystis Pneumonia in China: The Clinical Practice in Real World." BioMed Research International 2019 (February 17, 2019): 1–11. http://dx.doi.org/10.1155/2019/6057028.

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We aimed to develop and validate a predictive model to evaluate in-hospital mortality risk in HIV/AIDS patients with PCP in China. 1001 HIV/AIDS patients with PCP admitted in the Beijing Ditan hospital from August 2009 to January 2018 were included in this study. Multivariate Cox proportional hazard model was used to identify independent risk factors of death, and a predictive model was devised based on risk factors. The overall in-hospital mortality was 17.3%. The patients were randomly assigned into derivation cohort (801cases) and validation cohort (200 cases) in 8:2 ratio, respectively, in which in derivation cohort we found that 7 predictors, including LDH >350U/L, HR>130 times/min, room air PaO2 <70mmHg, later admission to ICU, Anemia (HGB≤90g/L), CD4<50cells/ul, and development of a pneumothorax, were associated with poor prognosis in HIV/AIDS patients with PCP and were included in the predictive model. The model had excellent discrimination with AUC of 0.904 and 0.921 in derivation and validation cohort, respectively. The predicted scores were divided into two groups to assess the in-hospital mortality risk: low-risk group (0-11 points with mortality with 2.15-12.77%) and high-risk group (12-21 points with mortality with 38.78%-81.63%). The cumulative mortality rate also indicated significant difference between two groups with Kaplan-Meier curve (p<0.001). A predictive model to evaluate mortality in HIV/AIDS patients with PCP was constructed based on routine laboratory and clinical parameters, which may be a simple tool for physicians to assess the prognosis in HIV/AIDS patients with PCP in China.

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Saccente, Michael, and Gayathri Krishnan. "Comparison of Blood (1–>3)-β-d-Glucan Levels in AIDS-Related Pneumocystis jirovecii Pneumonia and AIDS-Related Progressive Disseminated Histoplasmosis." Clinical Infectious Diseases 73, no. 6 (March 31, 2021): 1100–1102. http://dx.doi.org/10.1093/cid/ciab277.

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Abstract In this retrospective study, (1–>3)-β-d-glucan (B-glucan) was an unreliable marker for AIDS-related Pneumocystis jirovecii pneumonia (PCP) because a high percentage of participants with progressive disseminated histoplasmosis and respiratory symptoms had a positive B-glucan result. Where histoplasmosis is common, attributing B-glucan positivity to PCP without further testing risks misdiagnosis.

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19

&NA;. "Zidovudine & PCP prophylaxis: patterns of use in AIDS." Inpharma Weekly &NA;, no. 1016 (December 1995): 12. http://dx.doi.org/10.2165/00128413-199510160-00024.

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&NA;. "Trimetrexate - an alternative to cotrimoxazole for PCP in AIDS." Inpharma Weekly &NA;, no. 953 (September 1994): 17. http://dx.doi.org/10.2165/00128413-199409530-00035.

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21

&NA;. "Treatments and prophylactic agents for PCP in AIDS compared." Inpharma Weekly &NA;, no. 838 (May 1992): 18–19. http://dx.doi.org/10.2165/00128413-199208380-00038.

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22

&NA;. "Is adjunctive corticosteroid therapy beneficial in AIDS-related PCP?" Inpharma Weekly &NA;, no. 744 (July 1990): 3. http://dx.doi.org/10.2165/00128413-199007440-00005.

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BAVA, Amadeo Javier, Sylvia CATTÁNEO, and Enrique BELLEGARDE. "Diagnosis of pulmonary pneumocystosis by microscopy on wet mount preparations." Revista do Instituto de Medicina Tropical de São Paulo 44, no. 5 (October 2002): 279–82. http://dx.doi.org/10.1590/s0036-46652002000500009.

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We have compared the searching of the presence of "honeycomb" structures by direct microscopy on wet mount preparations with the direct immunofluorescence (DIF) for the diagnosis of Pneumocystis carinii pneumonia (PCP) in 115 bronchoalveolar (BAL) fluids. The samples belonged to 115 AIDS patients; 87 with presumptive diagnosis of PCP and 28 with presumptive diagnosis other than PCP. The obtained results were coincident in 114 out of 115 studied samples (27 were positive and 87 negative) with both techniques. A higher percentage of positive results (32.18%) among patients with presumptive diagnosis of PCP with respect to those with presumptive diagnosis other than PCP (3.57%) was observed. One BAL fluid was positive only with DIF, showed scarce and isolated P. carinii elements and absence of typical "honeycomb" structures. The searching for "honeycomb" structures by direct microscopy on wet mount preparations could be considered as a cheap and rapid alternative for diagnosis of PCP when other techniques are not available or as screening test for DIF. This method showed a sensitivity close to DIF when it was applied to BAL fluids of AIDS patients with poor clinical condition and it was performed by an experienced microscopist.

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Guimarães, Mark Drew Crosland. "Estudo temporal das doenças associadas à AIDS no Brasil, 1980-1999." Cadernos de Saúde Pública 16, suppl 1 (2000): S21—S36. http://dx.doi.org/10.1590/s0102-311x2000000700003.

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Neste trabalho foram estimadas as incidências de condições associadas (CA) à AIDS/100 casos de AIDS em adultos (> 12 anos), a nível nacional, de 1980 a maio de 1999. A análise incluiu qui-quadrado e regressão linear simples. As CA analisadas foram candidíase (CD), tuberculose (TB), pneumonia por Pneumocystis carinii (PCP), neurotoxoplasmose(NT), Herpes, Sarcoma de Kaposi (SK), meningite criptocócica (MC) e infecções por protozoários (IP). As incidências acumuladas/100 casos de AIDS foram: CD = 59, TB = 26, PCP = 23, NT = 15, Herpes = 12, SK = 5, MC = 4 e IP = 4. A tendência anual indicou queda estatisticamente significativa em todas as CA. Entretando, houve aumento na incidência de TB (b = 0,39) e NT (b = 0,20), para as regiões Nordeste e Centro-Oeste, respectivamente. TB apresentou maior incidência entre aqueles com baixa escolaridade (< 8 anos), enquanto que PCP e SK tiveram maiores incidências entre aqueles com melhor escolaridade (8+ anos), apesar de declínios semelhantes. Acesso à terapia anti-retroviral e profilaxias para as CA explicam parcialmente estes resultados. Entretanto, a confiabilidade dos dados, o atraso na notificação, a incidência de CA pós-AIDS, bem como os critérios de notificação e diagnóstico, são fatores que devem ser avaliados.

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Okazaki, Moemi, Masafumi Okazaki, Miho Nakamura, Tadashi Asagiri, and Seisho Takeuchi. "Consecutive hypoglycemia attacks induced by co-trimoxazole followed by pentamidine in a patient with acquired immunodeficiency syndrome." International Journal of STD & AIDS 30, no. 1 (August 31, 2018): 86–89. http://dx.doi.org/10.1177/0956462418795580.

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Both co-trimoxazole and pentamidine are used for the treatment of pneumocystis pneumonia (PCP) and are known to cause hypoglycemia as an adverse drug reaction. Here, we describe a rare case of a late-diagnosed female patient with acquired immunodeficiency syndrome (AIDS) who developed the first hypoglycemic attack as an adverse effect of co-trimoxazole, followed by a second hypoglycemic attack as an adverse effect of pentamidine. Physicians caring for patients with AIDS and PCP should be aware of possible hypoglycemia in patients with many risk factors.

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Amsden, Guy W., Steven F. Kowalsky, and Gene D. Morse. "Trimetrexate for Pneumocystis Carinii Pneumonia in Patients with Aids." Annals of Pharmacotherapy 26, no. 2 (February 1992): 218–26. http://dx.doi.org/10.1177/106002809202600217.

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OBJECTIVE: The primary objective of this article is to introduce readers to the use of a new agent, trimetrexate (TMTX), in the treatment of Pneumocystis carinii pneumonia (PCP). The article also gives the readers an overview of PCP and discusses some of the controversies surrounding it. Pharmacokinetic data and clinical trials are reviewed, as well as adverse effects, drug interactions, and dosage guidelines. DATA SOURCES: A MEDLINE search was used to identify pertinent literature, including reviews. STUDY SELECTION: As both pharmacokinetic and clinical trials were few in number, all available trials were reviewed. DATA EXTRACTION: Pharmacokinetic data from trials involving patients with AIDS was sparse; therefore, those involving oncology patients, including a pediatric population, were included. Although more trials need to be done in AIDS patients, the results from the oncologic trials give us a baseline from which to extrapolate. All clinical trials available at the time of publication were reviewed as were all of the preliminary results from three ongoing trials, which were made available through a personal communication. DATA SYNTHESIS: TMTX has been found to be 1500 times more potent than trimethoprim as a dihydrofolate reductase inhibitor, and has the potential to provide an effective therapeutic option for PCP. TMTX is a lipid-soluble analog of methotrexate and is thus capable of greater penetration into Pneumocystis cells, which lack the folate membrane transport system necessary to take up classic folate structures like leucovorin and methotrexate, thereby negating any clinical effectiveness of methotrexate and allowing leucovorin to be used for host cell rescue. TMTX's pharmacokinetic parameters best fit a multicompartmental model with a terminal half-life of up to 12 hours. It is cleared both hepatically and renally with up to 41 percent excreted unchanged in the urine. Although TMTX's pharmacokinetic parameters are variable, the need for plasma concentration monitoring at present is unclear, as no dose-response relationship has been established. Efficacy trials involving TMTX have been conducted mostly in patients with moderate to severe PCP who were either intolerant and/or refractory to standard therapies. Response rates to TMTX therapy have ranged from 6 to 90 percent, thereby demonstrating that TMTX may be useful in the treatment of certain patients with PCP. CONCLUSIONS: Although more well-designed clinical trials comparing TMTX with standard therapies are necessary, initial results indicate that TMTX is a promising alternative for moderate to severe episodes of PCP. Also, additional studies of TMTX's use as a prophylactic agent in PCP, and when it should be initiated in relation to a patient's CD4 count are needed. Furthermore, difficulty may arise in using TMTX on a regular basis because of the potential cost of therapy with concomitant leucovorin.

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Sun, Jia, Junwei Su, Yirui Xie, Michael T. Yin, Ying Huang, Lijun Xu, Qihui Zhou, and Biao Zhu. "Plasma IL-6/IL-10 Ratio and IL-8, LDH, and HBDH Level Predict the Severity and the Risk of Death in AIDS Patients withPneumocystisPneumonia." Journal of Immunology Research 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/1583951.

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Objective. To identify blood biomarkers to predict severity and mortality in AIDS PCP patients.Methods. Biomarkers including clinical parameters and plasma inflammatory cytokines were assessed in 32 HIV-infected patients withPneumocystispneumonia (PCP) at time of admission. Predictive value of the biomarkers for clinical severity and in-hospital mortality was evaluated by corresponding ROC curve.Results. Levels of CRP, WBC, LDH, HBDH, and Ferritin were significantly higher in the severe and nonsurvivor AIDS PCP patients. These important biochemical indicators have inverse correlation with oxygenation index, especially levels of LDH (P=0.008,R2=0.258), HBDH (P=0.001,R2=0.335), and Ferritin (P=0.005,R2=0.237). Plasma IL-8 and IL-6 levels were significantly higher in patients with PaO2/FiO2≤ 200 mmHg and nonsurvivors than in those with PaO2/FiO2> 200 mmHg and survivors. Severe and nonsurvival groups showed higher ratio of mean IL-6/IL-10 level (1.78 ± 1.56,P<0.001; 1.11 ± 0.72,P=0.043), larger AUC (95% CI 0.781–1.000,P<0.001; 95% CI 0.592–0.917,P=0.043), and more significantly inverse correlation with the oxygenation index.Conclusion. Plasma IL-8, LDH, and HBDH levels and IL-6/IL-10 ratio could be helpful for early evaluation of the severity and predicting fatal outcomes in AIDS PCP patients.

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Beck, E. J., P. D. French, M. H. Helbert, D. S. Robinson, F. M. Moss, J. R. W. Harris, A. J. Pinching, and D. M. Mitchell. "Improved Outcome of Pneumocystis Carinii Pneumonia in AIDS Patients: A Multifactorial Treatment Effect." International Journal of STD & AIDS 3, no. 3 (May 1992): 182–87. http://dx.doi.org/10.1177/095646249200300305.

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Factors determining the outcome of an episode of Pneumocystis carinii pneumonia (PCP) in 149 AIDS patients treated at St Mary's Hospital were identified and their importance on improved survival evaluated between 1984 and 1989. The proportion of fatal episodes of PCP decreased over time. Fatal compared with non-fatal episodes had lower mean alveolar-arterial oxygen gradient (82.5 mmHg vs 53.8 mmHg, P<0.001), mean haemoglobin level (11.2g/dl vs 12.1 g/dl, P=0.01), mean lymphocyte count (0.68 times 109/l vs 0.92 times 109/l, P=0.05) and more coinfections (31% vs 5%, P<0.001). Over time, the most significant change which occurred was a reduction in alveolar-arterial oxygen gradient at time of first presentation with PCP (r=−0.37, P<0.001). Mean alveolar-arterial oxygen gradient declined from 79.9 mmHg in 1984 to 45.3 mmHg in 1989 (r= −0.88, P=0.02), independently of zidovudine therapy or PCP prophylaxis. Patients were being treated at an earlier stage in their disease course as indicated by their reduced alveolar arterial oxygen gradient. This is due either to earlier patient presentation, earlier medical diagnosis or both. The widespread introduction of zidovudine and PCP prophylaxis may further contribute to improve morbidity and mortality patterns in the future.

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Roths, J. B., A. L. Smith, and C. L. Sidman. "Lethal exacerbation of Pneumocystis carinii pneumonia in severe combined immunodeficiency mice after infection by pneumonia virus of mice." Journal of Experimental Medicine 177, no. 4 (April 1, 1993): 1193–98. http://dx.doi.org/10.1084/jem.177.4.1193.

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Mice homozygous for the mutant allele scid (severe combined immunodeficiency) have been described as excellent models for Pneumocystis carinii (Pc) pneumonia (PCP), a major health problem in patients with acquired immune deficiency syndrome (AIDS) and other immunodeficiency states. Other microorganisms have been shown to infect AIDS patients simultaneously with Pc, but whether one opportunist is able to directly influence the pathogenicity of another has not been determined previously. We have deliberately coinfected scid mice (with extent Pc infection) with a variety of primarily pneumotropic viruses and bacteria and have identified pneumonia virus of mice as causing a dramatic increase in the density of Pc organisms and the morbidity due to PCP in immunodeficient scid mice. This finding has clinical significance in the management of PCP, in that the identification and treatment of coinfecting pneumotropic pathogens may be as important as treatment targeted at Pc. A search for other synergistic (or antagonistic) microorganisms and determination of their mechanism(s) of action in altering the progression of PCP is indicated.

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Sarmento e Castro, R., O. Vasconcelos, F. Carneiro, and A. Rocha-Marques. "Hepatic pneumocystosis without concomitant PCP in a patient with AIDS." Journal of Infection 34, no. 3 (May 1997): 257–59. http://dx.doi.org/10.1016/s0163-4453(97)94367-x.

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Guillemi, Silvia, Allan Belzberg, Lindsay M. Lawson, Martin T. Schechter, and Julio SG Montaner. "Adjunctive Corticosteroid Therapy Decreases Lung Permeability in Patients with AIDS-RelatedPneumocystis cariniiPneumonia." Canadian Respiratory Journal 2, no. 1 (1995): 55–58. http://dx.doi.org/10.1155/1995/806746.

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OBJECTIVE: To assess the effect of adjunctive corticosteroid therapy on lung permeability as measured by Tc-DTPA lung clearance scan in patients with AIDS-relatedPneumocystis cariniipneumonia (PCP).METHODS: Sixteen patients with microbiologically proven AIDS-related PCP were prospectively studied using sequential Tc-DTPA lung clearance scan. All patients received slant.lard antimicrobial treatment. Six patients received adjunctive oral corticosteroids in addition to the usual antimicrobial therapy. Tc-DTPA lung clearance scan was performed al baseline and during the second week of therapy. All scans were read by a blinded single observer using a standardized protocol.RESULTS: Baseline Tc-DTPA lung clearance halftime (T12) was 12±2 and 9±1 mins in the noncorticosteroid and corticosteroid treated groups, respectively. During the second week of therapy, Tc-DTPAT12lung clearance was 17±8 and 24±9 mins for the noncorticosteroid and corticosteroid treated groups, respectively. The change in Tc-DTPA lung clearance between baseline and week 2 was significantly greater (P<0.02) in the corticosteroid treated patients.CONCLUSION: Data suggest that the use of adjunctive corticosteroid therapy decreases lung permeability, as measured by Tc-DTPA lung clearance scan, in patients with AIDS-related PCP.

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Gigliotti, Francis, and Terry W. Wright. "Immunopathogenesis of Pneumocystis carinii pneumonia." Expert Reviews in Molecular Medicine 7, no. 26 (November 14, 2005): 1–16. http://dx.doi.org/10.1017/s1462399405010203.

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Pneumocystis carinii pneumonia (PCP) is a life-threatening infection that occurs in immunocompromised individuals, particularly those with advanced human immunodeficiency virus (HIV) infection. Interestingly, morbidity and mortality is related to the underlying cause of immunosuppression, with AIDS patients faring better than oncology patients for example. In addition, the prognosis of PCP has been correlated with markers of inflammation rather than with organism numbers. There is now increasing evidence that lung damage occurring during PCP is a result of the type and extent of the host inflammatory response to P. carinii rather than a result of direct damage by the organism. This review will discuss the experimental and clinical data demonstrating how the host-mediated inflammatory response to infection with P. carinii determines the ultimate outcome of PCP. A better understanding of the pathophysiology of PCP should lead to the development of improved therapies for the treatment of PCP.

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Bonora, S., M. Lanzafame, B. Allegranzi, F. Soldani, S. Vento, A. Cazzadori, G. Di Perri, and E. Concia. "Comparative evaluation of naturally occurring Pneumocystis carinii pneumonia (PCP) and PCP despite primary chemoprophylaxis in patients with AIDS." Journal of Infection 35, no. 2 (September 1997): 201. http://dx.doi.org/10.1016/s0163-4453(97)92073-9.

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Nowaseb, Vincent, Esegiel Gaeb, Marcin G. Fraczek, Malcolm D. Richardson, and David W. Denning. "Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia." Journal of Infection in Developing Countries 8, no. 03 (March 13, 2014): 349–57. http://dx.doi.org/10.3855/jidc.3864.

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Introduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. Methodology: Randomly collected sputum samples were analysed by microscopy after Grocott’s methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. Results: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. Conclusion: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill.

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Mitha, Mohammed, Kriban Reddy, Raveen Parboosing, and Yacoob Coovadia. "An interesting case of HSV pneumonia and PCP co-infection in a patient with AIDS: A diagnostic and management challenge." Southern African Journal of HIV Medicine 10, no. 1 (March 23, 2009): 2. http://dx.doi.org/10.4102/sajhivmed.v10i1.997.

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The advent of HIV and AIDS has brought about many diagnostic and management challenges regarding multiple opportunistic infections. Pneumocystis jirovecii pneumonia (PCP) is a common presentation in patients with AIDS who are not on prophylaxis or highly active antiretroviral therapy (HAART). Herpes simplex 1 virus (HSV-1) is a ubiquitous virus that mainly causes benign disease during primary infection. However, it is known to cause severe pneumonia and disseminated disease in the immunocompromised.1 We present a case of HSV-1 pneumonitis and PCP co-infection in an HIV-positive patient with respiratory failure. To the best of our knowledge, based on Pubmed and Google Scholar searches, this is the first case to be reported in the English language literature.

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&NA;. "Eflornithine: can work when others have failed in AIDS-related PCP." Inpharma Weekly &NA;, no. 767 (December 1990): 7. http://dx.doi.org/10.2165/00128413-199007670-00016.

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El-Zeftawy, H., H. Abujudeh, M. Azia, S. Naddaf, W. Omar, S. Atay, M. Kumar, et al. "Changing Patterns of PCP Infection After Prophylactic Treatment in AIDS Patients." CLINICAL NUCLEAR MEDICINE 23, no. 2 (February 1998): 137. http://dx.doi.org/10.1097/00003072-199802000-00057.

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Wang, Jing, Terry W. Wright, and Francis Gigliotti. "Immune Modulation as Adjunctive Therapy forPneumocystispneumonia." Interdisciplinary Perspectives on Infectious Diseases 2011 (2011): 1–7. http://dx.doi.org/10.1155/2011/918038.

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Pneumocystisis an opportunistic fungal respiratory pathogen that causes life-threatening pneumonia (Pcp) in patients suffering from defects in cell-mediated immunity, including those with acquired immunodeficiency syndrome (AIDS) and immunosuppression secondary to chemotherapy or organ transplantation. Despite major advances in health care, the mortality associated with Pcp has changed little over the past 25 years. Pcp remains a leading cause of death among HIV infected patients, with mortality rates of 50% or higher for patients developing severe Pcp. In addition, as more potent immunosuppressive therapies are developed for chronic inflammatory diseases, more cases of Pcp are occurring in non-HIV patients and in previously unreported clinical settings. These features highlight the importance of developing a better understanding of the pathogenesis of this disease, and the need to search for new therapeutic strategies to improve the outcome of Pcp patients. Immune-mediated inflammatory responses play an important role in the pathogenesis of Pcp, and may be even more significant in determining the outcome of Pcp than direct damage due to the organism itself. In this review we will summarize the immunopathogenic mechanisms that contribute to Pcp-associated lung injury, and discuss the potential to target these pathways for adjunctive immune modulation therapy for Pcp.

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Gingerich, Aaron D., Karen A. Norris, and Jarrod J. Mousa. "Pneumocystis Pneumonia: Immunity, Vaccines, and Treatments." Pathogens 10, no. 2 (February 19, 2021): 236. http://dx.doi.org/10.3390/pathogens10020236.

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For individuals who are immunocompromised, the opportunistic fungal pathogen Pneumocystis jirovecii is capable of causing life-threatening pneumonia as the causative agent of Pneumocystis pneumonia (PCP). PCP remains an acquired immunodeficiency disease (AIDS)-defining illness in the era of antiretroviral therapy. In addition, a rise in non-human immunodeficiency virus (HIV)-associated PCP has been observed due to increased usage of immunosuppressive and immunomodulating therapies. With the persistence of HIV-related PCP cases and associated morbidity and mortality, as well as difficult to diagnose non-HIV-related PCP cases, an improvement over current treatment and prevention standards is warranted. Current therapeutic strategies have primarily focused on the administration of trimethoprim-sulfamethoxazole, which is effective at disease prevention. However, current treatments are inadequate for treatment of PCP and prevention of PCP-related death, as evidenced by consistently high mortality rates for those hospitalized with PCP. There are no vaccines in clinical trials for the prevention of PCP, and significant obstacles exist that have slowed development, including host range specificity, and the inability to culture Pneumocystis spp. in vitro. In this review, we overview the immune response to Pneumocystis spp., and discuss current progress on novel vaccines and therapies currently in the preclinical and clinical pipeline.

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Otieno-Odhiambo, Patricia, Sean Wasserman, and J. Claire Hoving. "The Contribution of Host Cells to Pneumocystis Immunity: An Update." Pathogens 8, no. 2 (April 19, 2019): 52. http://dx.doi.org/10.3390/pathogens8020052.

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Pneumocystis is a ubiquitous atypical fungus that is distributed globally. The genus comprises morphologically similar but genetically heterogeneous species that have co-evolved with specific mammalian hosts as obligate intra-pulmonary pathogens. In humans, Pneumocystis jirovecii is the causative organism of Pneumocystis pneumonia (PCP) in immunocompromised individuals, a serious illness frequently leading to life-threatening respiratory failure. Initially observed in acquired immunodeficiency syndrome (AIDS) patients, PCP is increasingly observed in immunocompromised non-AIDS patients. The evolving epidemiology and persistently poor outcomes of this common infection will require new strategies for diagnosis and treatment. A deeper understanding of host immune responses and of the cells that mediate them will improve the chance of developing new treatment strategies. This brief review provides an update on recent studies on the role of host immunity against Pneumocystis.

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Riyanto, Dahlia, Rindang Tanjungsari, Tri Pudy Asmarawati, and Desiana Radithia. "ORAL CANDIDIASIS IN HIV PATIENT SUFFERING PNEUMOCYSTIC CARINII PNEUMONIA." Dentino : Jurnal Kedokteran Gigi 5, no. 1 (March 12, 2020): 70. http://dx.doi.org/10.20527/dentino.v5i1.8126.

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Background: HIV/AIDS infection provoked opportunistic infection systhemically and intraorally. Pneumocystic carinii pneumonia (PCP) and Oral candidiasis (OC) is the most prevalent opportunistic infection among HIV/AIDS patient and may serve as indicator of low CD4 count in HIV infection. Objective: This paper reports management of oral candidiasis in pneumocystic carinii pneumonia that affects a patient with HIV. Case: A 39 year-old man was hospitalized for pneumocystic carinii pneumonia with weakness of gait and emaciated posture. He was also diagnosed of HIV/AIDS infection through CD4 count and HIV rapid test. Intraoral white patches was reported occured within 2 days being hospitalized. Several tests were ordered resulting, metabolic acidosis, CD4 count were 10 cells/μL, HIV rapid test (ICT) was reactive for 3 methods, and microbiologic examination was positif to C.albicans from the smear of white plaque. The patient also diagnosed with OC pseudomembranous type. Case Management: Patient was treated using intravenous fluconazole 100 mg/day for five days and antiseptic mouthwash. Recovery was achieved within 3 weeks follow-up along with given anti retroviral (ARV) treatment by the internist. Conclusion: Management of OC in HIV/AIDS patient with PCP infection in this case were used systemic antifungal and antiseptic mouthwash. The multidiciplinary approach in managing this case obtained successful therapy.

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Andersen, Richard, Melissa Boedicker, Mary Ma, and Ellie J. C. Goldstein. "Adverse Reactions Associated with Pentamidine Isethionate in Aids Patients: Recommendations for Monitoring Therapy." Drug Intelligence & Clinical Pharmacy 20, no. 11 (November 1986): 862–68. http://dx.doi.org/10.1177/106002808602001108.

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Since pentamidine has become commercially available, there is renewed interest in using it as the initial treatment for Pneumocystis carinii pneumonia (PCP) in AIDS patients. We reviewed the use of pentamidine in 24 patients with PCP to gain information on the prevalence and severity of adverse effects from this drug. Twenty out of twenty-four patients (83 percent) experienced some kind of adverse effect. Hepatic abnormalities (58 percent), nausea and vomiting (46 percent), hypoglycemia (33 percent), azotemia (25 percent), and pain at the injection site (25 percent) were the most frequently seen effects. We recommend monitoring guidelines to be applied during pentamidine therapy based on the observed frequency of specific side effects.

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Peruzzi, William T., Barry A. Shapiro, Gary A. Noskin, Donna L. Currie, Anthanasios Skoutelis, Robert L. Murphy, Roy D. Cane, and Michael J. Blake. "Concurrent Bacterial Lung Infection in Patients with AIDS, PCP, and Respiratory Failure." Chest 101, no. 5 (May 1992): 1399–403. http://dx.doi.org/10.1378/chest.101.5.1399.

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Sistek, Catherine J., Cindy J. Wordell, and Stephen P. Hauptman. "Adjuvant Corticosteroid Therapy for Pneumocystis Carinii Pneumonia in Aids Patients." Annals of Pharmacotherapy 26, no. 9 (September 1992): 1127–33. http://dx.doi.org/10.1177/106002809202600915.

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OBJECTIVE: To review published abstracts, case reports, and journal articles and evaluate data examining the use of systemic corticosteroids as adjuvant treatment for Pneumocystis carinii pneumonia (PCP) in patients with AIDS. DATA SOURCES: Computerized online databases, peer-reviewed journals from January 1986 through September 1991, and personal communication with a National Institutes of Health correspondent. STUDY SELECTION: The authors identified 13 reports pertinent to this review. By author consensus, five studies were selected for analysis based on sample size, controlled study design, and clinical outcome measures. Recommendations of an expert panel from the National Institutes of Health and the University of California also are discussed. DATA EXTRACTION: Data are presented based on the methodologic strength of the studies reviewed. Studies are assessed on sample size, inclusion criteria, comparative cohort populations, specific patient outcome measures, and statistical analysis. DATA SYNTHESIS: Results of the study analysis support the use of systemic corticosteroids as early adjunctive therapy for AIDS patients with moderate-to-severe PCP who have an initial arterial oxygen partial pressure of <70 mm Hg or an alveolar-arterial gradient >35 mm Hg on room air. Improved outcomes included decreased mortality, respiratory failure, and deterioration of oxygenation. Data evaluated have shown that adjuvant corticosteroid therapy is most effective when initiated within 72 hours of beginning specific antipneumocystis therapy. A small, but sometimes significant, increased rate of infection in steroid-treated patients was noted. CONCLUSIONS: Based on the literature reviewed, early systemic adjuvant corticosteroid therapy can benefit patients with moderate-to-severe AIDS-related PCP. The steroid regimen used in the largest controlled trial and recommended by the expert panel is prednisone 40 mg bid (days 1–5), then 40 mg/d (days 6–10), then 20 mg/d (days 1–21).

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Ong, E. L. C. "The Role of Aerosol Pentamidine Prophylaxis." International Journal of STD & AIDS 4, no. 2 (March 1993): 67–69. http://dx.doi.org/10.1177/095646249300400202.

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Pneumocystis carinii pneumonia (PCP) is the most frequent opportunistic infection in patients with AIDS, occurring in 80% and recurring in 50% of patients within 12 months of the first episode. Prophylaxis for PCP is recommended if the CD4+ cell count is <200×106/l or 20% of the total lymphocyte count, or after an episode of PCP. The most effective prophylactic agent currently is trimethoprim-sulphamethoxazole and should be the drug of choice but alternatives such as aerosol pentamidine are being increasingly used for patients who cannot tolerate this combination or other oral preparations. If aerosol pentamidine is used and administered via a Respigard II Marquest nebulizer, the dosage should be higher than the currently recommended monthly dosage of 300 mg.

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Goheen, M. P., M. S. Bartlett, M. M. Shaw, S. R. Meshnick, and J. W. Smith. "Effects of Atovaquone on the Ultrastructural Morphology of Pneumocystis Carinii." Microscopy and Microanalysis 3, S2 (August 1997): 81–82. http://dx.doi.org/10.1017/s1431927600007297.

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Pneumocystis carinii pneumonia (PCP) occurs at some time in most patients with acquired immunodeficiency syndrome (AIDS). Trimethoprim/sulfamethoxazole or pentamidine isothionate are the traditional modes of therapy for treatment and prophylaxis of PCP. Unfortunately these drugs are associated with a significant incidence of adverse side effects particularly in patients with AIDS. Toxicity and a growing concern that P. carinii strains are becoming resistant to these compounds is providing the impetus for the search for additional drugs to combat P. carinii. Atovaquone, developed as an antimalarial agent, has activity against a wide range of other organisms, including Toxoplasma sp. and P. carinii, with a lower incidence of adverse reactions during clinical trials. Atovaquone inhibits mitochondrial respiration in P. falciparum and P. carinii. In this study transmission electron microscopy (TEM) was used to observe the effects of atovaquone on P. carinii organisms in short term spinner flask culture.Spinner flask cultures of human embryonic lung cells were inoculated with P. carinii from infected rat lung.

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Prevedoros, H. P., R. P. Lee, and D. Marriot. "CPAP, Effective Respiratory Support in Patients with AIDS-related Pneumocystis Carinii Pneumonia." Anaesthesia and Intensive Care 19, no. 4 (November 1991): 561–66. http://dx.doi.org/10.1177/0310057x9101900413.

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Human Immunodeficiency Virus (HIV) related Pneumocystis carinii pneumonia (PCP) associated with severe respiratory failure is an increasingly common problem in major centres and is associated with a high mortality in previous and recent studies. Early in the epidemic, alternatives to invasive intensive care treatment were utilized in our institution and found to be successful. When respiratory failure developed, mask CPAP was used instead of intubation and ventilation. A retrospective review of 175 cases of HIV infected patients with confirmed first presentation PCP was undertaken. Treatment with our protocol resulted in an overall hospital mortality of 9%. Those patients who did not require supplemental oxygen or respiratory support had no in-hospital mortality. The group who required supplemental oxygen had a mortality of 10%. If respiratory failure supervened (severe respiratory distress, Pao2 < 50 mmHg, SaO2 < 90% on mask oxygen), CPAP was introduced. The mortality in this group was 22%. Only two patients were admitted to the intensive care unit for respiratory support after failure of CPAP. Both patients were intubated and received intermittent positive pressure ventilation (IPPV). Both patients died.

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Fletcher, C. V., B. K. Goodroad, L. M. Cummins, K. Henry, H. H. Balfour, and F. S. Rhame. "Pharmacokinetics of hyperimmune anti-human immunodeficiency virus immunoglobulin in persons with AIDS." Antimicrobial Agents and Chemotherapy 41, no. 7 (July 1997): 1571–74. http://dx.doi.org/10.1128/aac.41.7.1571.

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Hyperimmune anti-human immunodeficiency virus immunoglobulin (HIVIG) is an intravenous immunoglobulin prepared from HIV-infected asymptomatic donors with a CD4 cell count greater than 400 cells/microl and a high titer of antibody to HIV-1 p24 protein. Twelve persons with AIDS received four doses of HMG (two at 50 mg/kg of body weight and then two at 200 mg/kg) every 28 days. Pharmacokinetics were evaluated by measurement of anti-p24 antibody. HIVIG was well tolerated, and all participants completed the study. Three subjects who were not receiving Pneumocystis carinii pneumonia (PCP) prophylaxis developed PCP. The mean value for HIVIG clearance was 3.02 ml/kg/day at 50 mg/kg and 3.65 ml/kg/day at 200 mg/kg (P = 0.027); the mean trough antibody titers (reciprocal units) were 1,442 and 4,428, respectively. This study indicates that high titers of anti-p24 antibody can be maintained with a monthly administration schedule of HIVIG and that short-term safety is acceptable. Comparisons to evaluate the therapeutic potential of HIVIG are justified.

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Yanagisawa, Kunio, Nuanjun Wichukchinda, Naho Tsuchiya, Michio Yasunami, Archawin Rojanawiwat, Hidenori Tanaka, Hiroh Saji, et al. "Deficiency of mannose-binding lectin is a risk of Pneumocystis jirovecii pneumonia in a natural history cohort of people living with HIV/AIDS in Northern Thailand." PLOS ONE 15, no. 12 (December 23, 2020): e0242438. http://dx.doi.org/10.1371/journal.pone.0242438.

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Background Mannose-binding lectin (MBL) plays a pivotal role in innate immunity; however, its impact on susceptibility to opportunistic infections (OIs) has not yet been examined in a natural history cohort of people living with HIV/AIDS. Methods We used archived samples to analyze the association between MBL expression types and risk of major OIs including Pneumocystis jirovecii pneumonia (PCP), cryptococcosis, talaromycosis, toxoplasmosis, and tuberculosis in a prospective cohort in Northern Thailand conducted from 1 July 2000 to 15 October 2002 before the national antiretroviral treatment programme was launched. Results Of 632 patients, PCP was diagnosed in 96 (15.2%) patients, including 45 patients with new episodes during the follow-up period (1006.5 person-years). The total history of PCP was significantly associated with low MBL expression type: high/intermediate (81/587, 13.8%), low (10/33, 30.3%) and deficient (5/12, 41.7%) (p = 0.001), whereas the history of other OIs showed no relation with any MBL expression type. Kaplan–Meier analysis (n = 569; log-rank p = 0.011) and Cox’s proportional hazards model revealed that deficient genotype dramatically increased the risk of PCP, which is independent upon sex, age, CD4 count, HIV-1 viral load and hepatitis B and C status (adjusted hazard ratio 7.93, 95% confidence interval 2.19–28.67, p = 0.002). Conclusions Deficiency of MBL expression is a strong risk factor determining the incidence of PCP but not other major OIs.

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Contini, C., R. Romani, M. Manganarot, F. Sorice, and S. Delia. "Tissue-culture isolation of Pneumocystis carinii from peripheral blood of AIDS patients with PCP." AIDS 7, no. 8 (August 1993): 1137–38. http://dx.doi.org/10.1097/00002030-199308000-00026.

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Journal articles on the topic 'AIDS; PCP'

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