Title: A Study on the Incidence of Pneumocystis Jiroveci Pneumoniae in HIV Patients in a Tertiary Care Hospital

Authors: Dr Brindha J, Dr R.Kaverikannan, Dr Suresh .P, Dr K.Shanmughasundaram, Dr Parvathy .S

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.50

Abstract

Introduction

Three of the 10 most common AIDS deficiency illnesses are recurrent bacterial pneumonia, TB and PCP pneumonia. Pneumocystis pneumonia once the hallmark of AIDS has dramatically declined in incidence following the development of effective prophylactic regimens and the widespread use of HAART. Pneumocystis is an opportunistic eukaryote that is classified as a fungus. The genus Pneumocystis infects mammalian species and is host-species specific. Infection in humans is caused by Pneumocystis jirovecii;. Humans are the only reservoir of P. jirovecii.

The risk of pcp is common among who have CD4+T cell counts of < 200/µL. Recurrent fever, non productive cough, night sweats and unexplained weight loss are the main clinical features of pcp. Symptoms may be subtle at first but gradually progress and may be present for several weeks before diagnosis.  The incidence of pcp is reaching zero in patients with known HIV infection receiving appropriate cART and prophylaxis in developed countries, the prevalence of AIDS related PCP in developing countries remains high and poorly controlled.

References

  1. Varela Jose M, Medrano Francisco J, Dei-Cas Eduardo Pneumocystis jirovecii Pneumonia in AIDS Patients, Microbes, Viruses and Parasites in AIDS Process, Prof. Zajac Vladim A˜ r,ed., 2011; ISBN: 978-953-307-601-0, In Tech, http://www.intechopen.com/books/microbes-virusesand-parasites-in-aidsprocess/pneumocystis-jirovecii-pneumonia-in-aids-patients.
  1. Fauci AS, Lane HC. 1998. Human Immunodeficiency Virus(HIV) Disease: AIDS and Related Disorders in Harrison’s principles of internal medicine, 20th ed. New York:McGraw-Hill.
  2. Ajello L, Hay RJ. “Medical Mycology” (Vol. 4) in Topley & Wilson’s Microbiology and Microbial Infections, 9th ed. London:Arnold; 1997.
  3. Chagas C. Nova tripanosomiazehumana. Mem Istit Oswaldo Cruz 1909;1:159–218.
  4. Stansell JD, Osmond DH, Charlebois E et al. Predictors of Pneumocystiscarinii pneumonia in HIV-infected persons. Pulmonary complications of HIV Infection Study Group. Am J Respir CritCare Med 1997;155(1):60–66.
  5. Bellamy R, Sangeetha S, PatonNI. AIDS-defining illnesses amongpatients with HIV in Singapore, 1985 to 2001: results from the Singapore HIV Observational Cohort Study (SHOCS). BMCInfect Dis 2004;4:47.
  6. Huang L, Beard CB, Creasman J, Levy D, Duchin JS, Lee S, PieniazekN, Carter JL, del Rio C, Rimland D, et al. Sulfa or sulfone prophylaxis and geographic region predict mutations in the Pneumocystis carinii dihydropteroate synthase gene. J Infect Dis 2000;182:1192–1198.
  7. Ripamonti C, Orenstein A, Kutty G, Huang L, Schuhegger R, Sing A,Fantoni G, Atzori C, Vinton C, Huber C, et al. Restriction fragment length polymorphism typing demonstrates substantial diversity among Pneumocystis jirovecii isolates. J Infect Dis 2009;200:1616–1622.
  8. Gianella S, Haeberli L, Joos B, Ledergerber B, Wuthrich RP, Weber R,Kuster H, Hauser PM, Fehr T, Mueller NJ. Molecular evidence of interhuman transmission in an outbreak of Pneumocystis jirovecii pneumonia among renal transplant recipients. Transpl Infect Dis 2010;12:1–10.
  9. Walzer PD, Perl DP, Krogstad DJ, Rawson PG, Schultz MG. Pneumocystiscarinii pneumonia in the United States. Epidemiologic, diagnostic, and clinical features. Ann Intern Med 1974;80:83–93.
  10. Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA,Saxon A. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. N Engl J Med 1981;305:1425–1431.
  11. Masur H, Michelis MA, Greene JB, Onorato I, Stouwe RA, Holzman RS, Wormser G, Brettman L, Lange M, Murray HW, et al. An outbreak of community-acquired Pneumocystis carinii pneumonia: initial manifestation of cellular immune dysfunction. N Engl J Med1981;305:1431–1438.
  12. WHO/UNAIDS. AIDS epidemic update [accessed September 30, 2010].Available from: http://dataunaidsorg/pub/Report/2009/JC1700_Epi_Update_2009_enpdf 2009.
  13. Centers for Disease Control and Prevention. HIV/AIDS surveillance report. 1990.
  14. Centers for Disease Control and Prevention. HIV/AIDS surveillanc

Corresponding Author

Dr Parvathy .S

Junior Resident, Department of  General Medicine, Kanyakumari  Government Medical College