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

Abstract

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.

Prevalence of Pneumocystis jirovecii pneumonia (2010–2013): The first Croatian report

“…The prevalence of PCP pneumonia in Croatian HIV-infected patients (57.7%) was comparable to that recorded in some developing countries such as Thailand (57%) [16], Malaysia (62.7%) [17] and Vietnam (55%) [18].Some developed countries such as China, reported even higher prevalence of PCP (70.22%) [19].In this study, the prevalence of HIV-infected patients was significantly higher prevalence of PCP compared to other groups. PCP pneumonia occurs primarily among HIV-positive persons who were not receiving antiretroviral therapy or PCP prophylaxis, and many were unaware of their HIV infection at the time of presentation [20].…”

Pneumocystis Pneumonia in Patients with Autoimmune Diseases: A Retrospective Study Focused on Clinical Characteristics and Prognostic Factors Related to Death

“…However, due to the increased use of chemotherapy and immunosuppressive agents, the incidence of PCP in HIV-negative patients has also increased. Unlike PCP in HIV patients, non-HIV PCP has a different clinical course and shows a higher mortality rate [ 1 , 2 , 3 , 4 ]. Recently, there are many reports about PCP in patients with autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), especially in patients receiving prolonged usage of prednisone, immunosuppressive agents or biologic agents [ 5 , 6 , 7 , 8 , 9 ].…”

Neumonía severa fatal por Pneumocistis jirovecii e Influenza A en un paciente con dermatomiositis amiopática y síndrome antisintetasa

“…Otro aspecto al cual conviene hacer referencia, es que tanto la presentación clínica, como el desenlace de la enfermedad, son diferentes en el paciente VIH positivo y en el paciente no VIH (26)(27)(28). En el primer grupo la enfermedad tiene un curso clínico más lento, con una mortalidad inferior al 10% (29,30). Sin embargo, en el segundo grupo de pacientes la enfermedad progresa rápidamente y es más severa (31).…”