Pneumocystis jirovecii pneumonia in Spanish HIV-infected patients in the combined antiretroviral therapy era: prevalence of dihydropteroate synthase mutations and prognostic factors of mortality

Simple item page
dc.contributor.authorAlvarez-Martínez, Miriam J.
dc.contributor.authorMoreno, Asunción
dc.contributor.authorMiro, Jose M.
dc.contributor.authorValls, Maria Eugenia
dc.contributor.authorRivas, Paula V.
dc.contributor.authorLazzari, Elisa de
dc.contributor.authorSued, Omar
dc.contributor.authorBenito, Natividad
dc.contributor.authorDomingo, Pere
dc.contributor.authorRibera, Esteban
dc.contributor.authorSantín, Miguel
dc.contributor.authorSirera, Guillermo
dc.contributor.authorSegura, Ferràn
dc.contributor.authorVidal, Francesc
dc.contributor.authorRodríguez, Francisco
dc.contributor.authorRiera, Melchor
dc.contributor.authorCordero, Maria Elisa
dc.contributor.authorArribas, Jose
dc.contributor.authorAnta, Maria Teresa Jiménez de
dc.contributor.authorGatell, Jose
dc.contributor.authorWilson, Paul E.
dc.contributor.authorMeshnick, Steven R.
dc.contributor.authorSpanish PCP Working Group
dc.date.accessioned2024-05-23T18:53:34Z
dc.date.available2024-05-23T18:53:34Z
dc.date.issued2008
dc.description.abstractThe incidence of Pneumocystis jirovecii pneumonia (PCP) in HIV-infected patients has decreased thanks to sulfa prophylaxis and combined antiretroviral therapy. The influence of P. jirovecii dihydropteroate synthase (DHPS) gene mutations on survival is controversial and has not been reported in Spain. This prospective multicenter study enrolled 207 HIV-infected patients with PCP from 2000 to 2004. Molecular genotyping was performed on stored specimens. Risk factors for intensive care unit (ICU) admission and mortality were identified using a logistic regression model. Seven patients (3.7%; 95% confidence interval [CI], 1.5-7.5%) had DHPS mutations. Overall mortality was 15% (95% CI, 10-21%), rising to 80% (95% CI, 61-92%) in patients requiring mechanical ventilation. None of the patients with DHPS mutants died, nor did they need ICU admission or mechanical ventilation. PaO(2) <60 mm Hg at admission was a predictor of ICU admission (P = 0.01), and previous antiretroviral therapy predicted non-ICU admission (P = 0.009). PaO(2) <60 mm Hg at admission and ICU admission during the 1st week were predictors of mortality (P = 0.03 and P < 0.001, respectively). The prevalence of DHPS mutants in Spain is low and is not associated with a worse outcome. Severe respiratory failure at admission is the strongest predictor of PCP outcome.
dc.identifier.citationAlvarez-Martínez, M. J., Moreno, A., Miro Jose M., Valls, M. E., Rivas, P. V., de Lazzari, E., ... Meshnick, S. R. (2008). Pneumocystis jirovecii pneumonia in Spanish HIV-infected patients in the combined antiretroviral therapy era: Prevalence of dihydropteroate synthase mutations and prognostic factors of mortality. Diagnostic Microbiology and Infectious Disease.
dc.identifier.otherDOI: 10.1016/j.diagmicrobio.2008.04.016
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1124
dc.relation.ispartofseriesDiagnostic Microbiology and Infectious Disease
dc.subjectPneumocystis jirovecii pneumonia
dc.subjectSpanish HIV-infected patients
dc.subjectAntiretroviral therapy era
dc.subjectPrognostic factors
dc.titlePneumocystis jirovecii pneumonia in Spanish HIV-infected patients in the combined antiretroviral therapy era: prevalence of dihydropteroate synthase mutations and prognostic factors of mortality

Files

Collections

Articulos científicos