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Rev Chilena Infectol · Apr 2015
Comparative Study[Pneumocystis jiroveci infection in patients with and without HIV: A comparison].
- Alejandro Rey, Cecilia Losada, Julieta Santillán, Fernando Fiorentini, María Schiaffino, Héctor J Peroni, Diego Giunta, Laura Barcán, and Gabriel Waisman.
- Rev Chilena Infectol. 2015 Apr 1; 32 (2): 175-80.
BackgroundRespiratory infection caused by Pneumocystis jiroveci is a common opportunistic infection in patients with human immunodeficiency virus (HIV) with CD4 counts < 200 cells/mm(3). However, it has also been reported in patients with other causes of immunosuppression.ObjectivesTo compare the characteristics, severity and mortality of respiratory infection by P. jiroveci in patients with and without HIV infection.MethodsRetrospective cohort follow-up of adult patients admitted to our hospital with infection by P. jiroveci since 2006 to 2013.ResultsWe included 82 patients with respiratory infection by P. jiroveci of which 55% (45) were not infected with HIV. In this group, 68.8% (31) had diagnosis of cancer and 20% (9) received solid-organ transplant. 57.9% (26) were hospitalized in an intensive care unit. 42.2% (19) suffered multiple organ failure (MOF), 46.7% (21) required mechanical ventilation (MV) and 40.9% (18) inotropic drugs. Mortality was 33.3% (15). Statistically significant differences were observed between groups in age (p < 0.001), requirement of MV (p < 0.001) inotropic drugs (p 0.001) and MOF (p < 0.001). Mortality was higher in the HIV-positive group, reaching statistical significance (p 0.007).ConclusionPneumocystis pneumonia mortality was higher in patients without HIV, who suffered more complications and progression to respiratory failure with MOF.
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