Laboratory findings and clinical characteristics of Pneumocystis pneumonia and tuberculosis infection among HIV-infected patients with pulmonary infiltrates in Jakarta, Indonesia

Rozaliyani, Anna; Wiyono, Wiwien Heru; Nawas, M A; Sijam, R; Adawiyah, Robiatul; Tugiran, Mulyati; Wahyuningsih, Retno

doi:10.47665/tb.37.4.1117

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…However, clinical features of PJP are nonspecific [ 9 ]. Traditionally, the diagnosis of PJP relies on comprehensive analyses of clinical manifestations, imaging findings, and microbiologic tests of sputum or bronchoalveolar lavage fluid (BALF) for Pneumocystis jirovecii [ 3 , 10 ]. In non-HIV immunocompromised patients, the sensitivity of conventional microbiological tests for sputum specimens is low, ranging from 38 to 53% [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of metagenomic next-generation sequencing for Pneumocystis jirovecii pneumonia

Xuefang

et al. 2023

BMC Infect Dis

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Objective Pneumocystis jirovecii pneumonia (PJP) can be a life-threatening opportunistic infection. We aimed to evaluate the diagnostic accuracy of metagenomic next-generation sequencing (mNGS) for PJP. Methods A comprehensive electronic literature search of Web of Knowledge, PubMed, Cochrane Library, CNKI and Wanfang data was performed. Bivariate analysis was conducted to calculate the pooled sensitivity, specificity, diagnostic odds ratio (DOR), the area under the summary receiver operator characteristic (SROC) curve and the Q-point value (Q*). Results The literature search resulted in 9 studies with a total of 1343 patients, including 418 cases diagnosed with PJP and 925 controls. The pooled sensitivity of mNGS for diagnosis of PJP was 0.974 [95% confidence interval (CI), 0.953–0.987]. The pooled specificity was 0.943 (95% CI, 0.926–0.957), the DOR was 431.58 (95% CI, 186.77-997.27), the area under the SROC curve was 0.987, and the Q* was 0.951. The I2 test indicated no heterogeneity between studies. The Deek funnel test suggested no potential publication bias. Subgroup analyses showed that the area under the SROC curve of mNGS for diagnosis of PJP in immunocompromised and non-HIV patients was 0.9852 and 0.979, respectively. Conclusions Current evidence indicates that mNGS exhibits excellent accuracy for the diagnosis of PJP. The mNGS is a promising tool for assessment of PJP in both immunocompromised and non-HIV patients.

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Section: Introductionmentioning

confidence: 99%

Diagnostic performance of metagenomic next-generation sequencing for Pneumocystis jirovecii pneumonia

Xuefang

et al. 2023

BMC Infect Dis

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Chest X-ray Features of HIV-Associated Pneumocystis Pneumonia (PCP) in Adults: A Systematic Review and Meta-analysis

Wills,

Adriaanse,

Erasmus

et al. 2024

Open Forum Infectious Diseases

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Objectives Performance of chest X-ray (CXR) features for PCP diagnosis has been evaluated in small studies. We conducted a systematic review and meta-analysis to describe CXR changes in adults with HIV-associated laboratory-confirmed PCP, comparing these to non-PCP respiratory disease. Methods We searched databases for studies reporting CXR changes in people > 15 years old with HIV and laboratory-confirmed PCP and those with non-PCP respiratory disease. CXR features were grouped using consensus terms. Proportions were pooled and odds ratios (OR) generated using random effects meta-analysis, with subgroup analyses by CD4 count, study period, radiology review method, and study region. Results 51 studies (with 1,821 PCP and 1,052 non-PCP cases) were included. Interstitial infiltrate (59%, 95% CI, 52-66%; 36 studies, n = 1,380, I2 85%) and ground-glass opacification (48%, 95% CI, 15-83%; 4 studies, n = 57, I2 86%) were common in PCP. Cystic lesions, central lymphadenopathy and pneumothorax were infrequent. Pleural effusion was rare in PCP (0% [95% CI, 0-2%]. Interstitial infiltrate (OR 2.3; 95% CI, 1.4-3.9; I2 = 60%); interstitial-alveolar infiltrate (OR 10.2 95% CI, 3.2-32.4; I2 = 0%); and diffuse CXR changes (OR 7.3; 95% CI, 2.7-20.2; I2 = 87%) were associated with PCP diagnosis. There was loss of association with alveolar infiltrate in African studies. Conclusions Diffuse CXR changes and interstitial-alveolar infiltrates indicate a higher likelihood of PCP. Pleural effusion, lymphadenopathy, or focal alveolar infiltrates suggest alternative causes. Findings could be incorporated into clinical algorithms to improve diagnosis of HIV-associated PCP.

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Serious fungal disease incidence and prevalence in Indonesia

Wahyuningsih

Adawiyah

Sjam

et al. 2021

Mycoses

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Background Indonesia is a tropical country, warm and humid, with numerous environmental fungi. Data on fungal disease burden help policymakers and clinicians. Objectives We have estimated the incidence and prevalence of serious fungal diseases. Methods We found all published and unpublished data and estimated the incidence and prevalence of fungal diseases based on populations at risk. HIV data were derived from UNAIDS (2017), pulmonary tuberculosis (PTB) data from 2013–2019, data on chronic pulmonary aspergillosis (CPA) were used to estimate CPA prevalence and likely deaths, COPD data from Hammond (2020), lung cancer incidence was from Globocan 2018, and fungal rhinosinusitis was estimated using community data from India. Results Overall ~7.7 million Indonesians (2.89%) have a serious fungal infection each year. The annual incidence of cryptococcosis in AIDS was 7,540. Pneumocystis pneumonia incidence was estimated at 15,400 in HIV and an equal number in non‐HIV patients. An estimated 1% and 0.2% of new AIDS patients have disseminated histoplasmosis or Talaromyces marneffei infection. The incidence of candidaemia is 26,710. The annual incidence of invasive aspergillosis was estimated at 49,500 and the prevalence of CPA is at 378,700 cases. Allergic bronchopulmonary aspergillosis prevalence in adults is estimated at 336,200, severe asthma with fungal sensitisation at 443,800, and fungal rhinosinusitis at 294,000. Recurrent vulvovaginal candidiasis is estimated at 5 million/year (15–50 years old). The incidence of fungal keratitis around 40,050. Tinea capitis prevalence in schoolchildren about 729,000. Conclusions Indonesia has a high burden of fungal infections.

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Laboratory findings and clinical characteristics of Pneumocystis pneumonia and tuberculosis infection among HIV-infected patients with pulmonary infiltrates in Jakarta, Indonesia

Cited by 3 publications

References 16 publications

Diagnostic performance of metagenomic next-generation sequencing for Pneumocystis jirovecii pneumonia

Diagnostic performance of metagenomic next-generation sequencing for Pneumocystis jirovecii pneumonia

Chest X-ray Features of HIV-Associated Pneumocystis Pneumonia (PCP) in Adults: A Systematic Review and Meta-analysis

Serious fungal disease incidence and prevalence in Indonesia

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