Early Predictors of Mortality from Pneumocystis jirovecii Pneumonia in HIV-Infected Patients: 1985-2006

Walzer, Peter D.; Evans, Hannah; Copas, Andrew; Edwards, Simon; Grant, Alison D.; Miller, R F

doi:10.1086/526778

Cited by 179 publications

(185 citation statements)

References 44 publications

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“…This result is different from a study that demonstrated that male and female patients appeared to have an equivalent risk for PCP in the USA (Kaplan et al, 1998), and is also different from a study conducted at the University College London Hospitals, UK, in which 94.3 % of the patients were male (Walzer et al, 2008). This can be explained by gender distribution in patients with different underlying diseases.…”

Section: Discussioncontrasting

confidence: 95%

“…For PCP patients with AIDS, this may be due to the different ways of HIV transmission in different regions. In China, the main factors for HIV infection were drug addiction and illegal blood donation (Jia et al, 2010;Li et al, 2010;Sheng & Cao, 2008;Wang, 2007), whilst in the London study, researchers declared that the main risk factor was sex with other males (Walzer et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…The epidemiological characteristics and outcome of HIV/ AIDS-associated PCP in developed countries have shifted multiple times over the course of the AIDS epidemic (Morris, 2008;Walzer et al, 2008). However, epidemiological data on PCP are lacking in mainland China.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Wang

Wei

et al. 2011

Journal of Medical Microbiology

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A retrospective study was performed on case reports of Pneumocystis pneumonia (PCP) from 1959 to 2009 in mainland China. The epidemiological characteristics of PCP over half a century were investigated over two time spans. The first was from 1959, when the first incidence of PCP was reported, to 1984, before the emergence of AIDS in mainland China. The second was from 1985, when the first AIDS case was reported in mainland China, to the end of 2009. A total of 2351 PCP cases were reported during these two time spans, covering a 51-year period. Only seven PCP cases were reported during the first time span. Six were diagnosed by autopsy, accordingly without treatment, whilst the other was diagnosed by open lung biopsy in a living patient who eventually recovered following treatment with sulfadiazine and pyrimethamine. The other 2344 PCP cases were reported during the second time span ) from 21 provinces, four municipalities and three autonomous regions. Among the 2344 PCP cases, 70.22 % (1646/2344) were identified together with human immunodeficiency virus (HIV) infection or were in AIDS patients. The remaining 698 non-HIV-infected patients had undergone organ transplantation, had other underlying diseases such as malignancy or hypoimmunity, or had undetermined diagnosis. The results of statistical analysis indicated that AIDS was the most common underlying disease of PCP for patients ,1 year and .14 years. For patients aged between 1 and 14 years, haematological malignancy was the most common underlying disease. The trend of the underlying diseases changed with time, showing that the number of PCP patients afflicted by HIV/AIDS increased dramatically, reaching almost threefold during the most recent 5 years compared with the level of the previous 10 years. The number of patients undergoing organ transplantation or with other underlying diseases rose constantly, but the number of malignancies tended to decline from 1995-2004 to 2005-2009. During the second time span (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009), most of the patients (97.61 %) were diagnosed alive and only 56 cases (2.39 %) were identified by autopsy. The mortality of PCP patients treated with anti-Pneumocystis drugs was 14.61 % for those with HIV/AIDS and 15.84 % for those without HIV/AIDS. For the PCP patients without anti-Pneumocystis treatment, all (100 %) of the HIV/AIDS-associated PCP patients died, whilst 13.79 % (4/29) of non-HIV-infected PCP patients survived. These data from epidemiological investigation of PCP in China over a period of half a century may provide useful information for prevention and the development of treatment of PCP.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Wang

Wei

et al. 2011

Journal of Medical Microbiology

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“…The overall in hospital mortality of this illness is in the region of 10-13%. Among the factors that have been associated with death in patients with PcP include older age, recent injection drug use, total bilirubin of greater than 0.6 mg/dl, serum albumin of less than 3 g/dl, alveolararterial oxygen gradient of equal or greater than 50 mm Hg, failure of cotrimoxazole treatment and the presence of co-morbidities such as bacterial pneumonia, Kaposis sarcoma and TB 55,56,57 . Patients who need to be admitted to the intensive care unit may suffer very high rates of deaths that could reach 80% within the ICU and up to 34 % three months post ICU admission 58 .…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Manifestations of HIV Disease

Chakaya¹

2011

HIV Infection in the Era of Highly Active Antiretroviral Treatment and Some of Its Associated Complications

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“…Patients without improvement in their CD4 count after starting cART remain at risk for PCP. One recent study showed that approximately 5% of HIV-infected persons have a CD4 count >200 cells/µL at presentation with PCP [19].…”

Section: Before the Onset Of The Aids Epidemic Pcp Was Uncommon In Thmentioning

confidence: 99%

Pneumocystis Pneumonia Associated with Human Immunodeficiency Virus

Miller

Huang

Walzer

2013

Clinics in Chest Medicine

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Early Predictors of Mortality from Pneumocystis jirovecii Pneumonia in HIV-Infected Patients: 1985-2006

Abstract: Mortality risk factors for PCP were identifiable at or soon after hospitalization. The trend towards improved outcome after June 1996 occurred in the absence of highly active antiretroviral therapy.

Cited by 179 publications

References 44 publications

Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Retrospective study of Pneumocystis pneumonia over half a century in mainland China

Pulmonary Manifestations of HIV Disease

Pneumocystis Pneumonia Associated with Human Immunodeficiency Virus

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