Retrospective comparative analysis of clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer

Abstract

Objective: To retrospectively compare the clinical, laboratory, and imaging features of Pneumocystis jirovecii pneumonia among HIV-infected individuals and patients with cancer in order to provide evidence for early detection, diagnosis, and treatment. Methods: Fourty-three patients with PJP diagnosed at the First Affiliated Hospital of Nanchang University from January 2017 to August 2022 were enrolled. Pneumocystis jirovecii pneumonia patients were divided into an HIV-infected group and a cancer group.A retrospective comparative analysis of clinical, laboratory, and imaging features was conducted in both groups.Statistical analysis using SPSS version 26.0 was performed. Results: Clinical indicators such as total protein, globulin,the ratio of albumin to globulin(AGR),γ-glutamyl transpeptidase(γ-GGT),alkaline phosphatase, triglyceride, total cholesterol,and blood glucose were statistically different in PJP-HIV and PJP-cancer.PJP-HIV patients mainly presented with upper respiratory symptoms, generally with fever as the first symptom,whereas the majority of PJP-cancer patients had systemic symptoms.Furthermore,PJP-HIV patients demonstrated early clinical and radiologic characteristics of lung diseases,while PJP-cancer patients had a later appearance.PJP-cancer patients had a longer length of hospital stay(58.8%,P=0.187),a higher rate of mechanical ventilation(11.1%,P＜0.05),and a higher probability of ICU admission（77.8%,P＜0.05）compared with PJP-HIVpatients. Conclusions: PJP-HIV patients presented with non-systemic symptoms and early abnormal lung imaging features, while PJP-cancer patients presented with systemic symptoms and late abnormal lung imaging features. Laboratory data for both groups, however, show significant statistical significance.