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Abstract
Pneumocystis jirovecii pneumonia (PCP) is emerging in HIV-negative patients, for whom the prognosis is significantly worse than in HIV-infected patients and risk factors are poorly characterized. We performed an observational, multi-centre, prospective study of 56 consecutive cases of documented PCP in HIV-negative patients, and found that: (1) the main underlying conditions were haematological malignancies (43%), solid tumours (25%), inflammatory diseases (20%), and solid organ transplantation (7%); (2) most patients (80%) had received prolonged corticosteroids, with a mean daily dose of 47.3 ± 32.8 mg equivalent prednisone when PCP was diagnosed, and a mean cumulative dose of 5807 ± 5048 mg over the last 12 months; and (3) the median CD4 cell count was 0.12 × 109/l (range 0.0–1.42), with a median CD4/CD8 ratio of 1.32 (0.0–6.4). These findings may be used to better target PCP prophylaxis according to the level of risk and contribute to decrease the burden of PCP in HIV-negative patients.
Acknowledgements
We are indebted to all of the patients who participated in the study and the healthcare workers who took care of them.
Declaration of interest: FR has received grants from Aventis, Novartis, Pfizer, and ViiV Healthcare for workshops or travel to meetings and accommodation. PT has received grants from Astellas, Astra-Zeneca, Aventis, Bristol-Myers Squibb, Galderma, Gilead Sciences, Janssen-Cilag, MSD, Novartis, Pfizer, and ViiV Healthcare for consultancy, workshops, or travel to meetings and accommodation. RV has received grants for travel and workshops from Bristol-Myers Squibb, Gilead Sciences, MSD, and ViiV Healthcare.
This study was supported by the French Ministry of Health (Programme Hospitalier de Recherche Clinique).