Pneumocystis Jirovecii Pneumonia In HIV-Infected Patients: A Single Center Experience

Öz

Objective: Pneumocystis jirovecii pneumonia (PCP) is still a critical opportunistic infection in patients diagnosed with the human immunodeficiency (HIV) infection in the advanced stages and patients who do not adhere to antiretroviral therapy. This study aimed to evaluate the clinical and diagnostic features of PCP infections developed in HIV-infected patients.Methods: HIV-infected patients aged 18 years and older, followed between January 2005 and March 2020 at the university hospital, were retrospectively reviewed from medical records. Results: Within the study's scope, 397 HIV-infected patients, 62 (15.6%) females and 335 (84.4%) males, with a mean age of 39.2 ± 11.6 years, were evaluated. While age was not a risk factor for developing PCP, the male gender was a risk factor. Patients with PCP had significantly lower CD4 lymphocytes counts than patients without PCP, and a CD4 lymphocyte count <200/mm3 significantly increased the disease's risk. The patients' most common systemic complaint was fever at the time of presentation, and the most common respiratory complaint was cough. The immunofluorescent antibody (IFA) test was positive in 57.1% of the patients. All patients had appearances that might be supportive for PCP in chest tomography.Conclusion: HIV infected male patients with advanced immunodeficiency constituted a high-risk group for developing PCP. In the presence of typical clinical findings, the evaluation of chest tomography and microbiological diagnostic tests together were found to be useful for accurate clinical diagnosis.

Anahtar Kelimeler

• HIV
• Acquired Immunodeficiency Syndrome
• Pneumocytis

HIV ile Enfekte Hastalarda Pneumocystis Jirovecii Pnömonisi: Tek Merkez Deneyimi

Öz

Amaç: Pneumocystis jirovecii pnömonisi (PCP), insan immünyetmezlik virüsü (HIV) ile enfekte ileri evre hastalarda ve antiretroviral tedavilerine uymayan kişilerde hala kritik bir fırsatçı enfeksiyondur. Bu çalışma, HIV ile enfekte hastalarda gelişen PCP enfeksiyonlarının klinik ve tanısal özelliklerini değerlendirmeyi amaçlamaktadır.Yöntem: Ocak 2005 ile Mart 2020 arasında üniversite hastanesinde izlenen 18 yaş ve üstü HIV ile enfekte hastaların tıbbi kayıtları geriye dönük olarak incelendi.Bulgular: Çalışma kapsamında; 62'si (%15,6) kadın, 335’i (%84,4) erkek ve yaş ortalaması 39,2 ± 11,6 yıl olan 397 HIV ile enfekte hasta değerlendirildi. Yaş, PCP'yi gelişimi açısından bir risk faktörü olarak bulunmasa da erkek cinsiyet risk faktörü olarak saptandı. PCP'li hastalar, PCP'si olmayan hastalara göre önemli ölçüde daha düşük CD4 lenfosit sayılarına sahipti ve CD4 lenfosit sayısının <200/mm3 olması, hastalık riskini önemli ölçüde arttırmaktaydı. Hastaların başvuru anında en yaygın sistemik şikâyeti ateş, en sık görülen solunum yolu şikâyeti ise öksürüktü. Hastaların %57,1'inde immünofloresan antikor (IFA) testi pozitifti. Tüm hastaların göğüs tomografisinde PCP'yi destekleyen görünümler saptandı.Sonuç: İleri düzeyde immün yetmezliği olan HIV ile enfekte erkek hastalar, PCP gelişimi için yüksek riskli olarak değerlendirildi. Tipik klinik bulguların varlığında, göğüs tomografisi ve mikrobiyolojik tanı testlerinin birlikte değerlendirilmesinin doğru klinik tanı için yararlı olduğu saptandı.

Anahtar Kelimeler

• HIV
• Edinilmiş İmmün Yetmezlik Sendromu
• Pnömosistis

Kaynakça

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