Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period

Background: In spite of the use of combination antiretroviral therapy and specific prophylaxis, Pneumocystis pneumonia remains one of the most common AIDS-defining disease with high mortality rate. The aim of this study is to analyze the cases of pneumocystis pneumonia over a three-year period by...

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Main Authors: Nina Yancheva, Dimitar Strashimirov, Maria Nikolova, Ivailo Alexiev, Aleksandra Ivanova, Nina Tsvetkova
Format: Article
Language:English
Published: National Center of Infectious and Parasitic Diseases 2020-12-01
Series:Problems of Infectious and Parasitic Diseases
Subjects:
Online Access:https://pipd.ncipd.org/index.php/pipd/article/view/47
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author Nina Yancheva
Dimitar Strashimirov
Maria Nikolova
Ivailo Alexiev
Aleksandra Ivanova
Nina Tsvetkova
author_facet Nina Yancheva
Dimitar Strashimirov
Maria Nikolova
Ivailo Alexiev
Aleksandra Ivanova
Nina Tsvetkova
author_sort Nina Yancheva
collection DOAJ
description Background: In spite of the use of combination antiretroviral therapy and specific prophylaxis, Pneumocystis pneumonia remains one of the most common AIDS-defining disease with high mortality rate. The aim of this study is to analyze the cases of pneumocystis pneumonia over a three-year period by means of assessing the mortality rate and the prognostic factors for the outcome of the disease.   Material and methods: Epidemiological, clinical, laboratory and demographic data were analyzed for 13 HIV-infected patients with proved pneumocystis pneumonia, hospitalized at the AIDS Department over the period January 2017–December 2019. For data processing we used different methods of descriptive statistics. Results: All presented patients have extremely severe immune deficiency and other opportunistic infections or AIDS-related diseases. The diagnosis of pneumocystis pneumonia was confirmed with PCR in 76.9% of the patients and with Giemsa staining for cysts and trophozoites in 23,1% of the patients. Most of our patients are male (84,6%) and the leading mechanism of HIV infection is unprotected homosexual contact. The mean age of the patients presented is 37.4 ± 10.27. Our results showed high PJP mortality (46.3 %), despite the applied etiological therapy. Conclusions: Pneumocystis jirovecii pneumonia (PJP) continues to be a life-threatening infection in HIV-infected patients with severe immune suppression. PJP mortality continues to be high, and there is a statistically significant dependence on age, male sex, low CD 4 T+ cell count, high viral load of HIV, low blood albumin, and the number and severity of comorbidities.
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spelling doaj.art-f38d45851b8545b4a62ef6a4ce70fbc92023-05-16T09:17:17ZengNational Center of Infectious and Parasitic DiseasesProblems of Infectious and Parasitic Diseases0204-91552815-28082020-12-0148310.58395/pipd.v48i3.47Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period Nina Yancheva0Dimitar Strashimirov1Maria Nikolova2Ivailo Alexiev3Aleksandra Ivanova4Nina Tsvetkova5Specialized Hospital for Active Treatment of Infectious and Parasitic DiseasesSpecialized Hospital for Active Treatment of Infectious and Parasitic Diseases “Prof. Ivan Kirov”National Centre of Infectious and Parasitic DiseasesNational Centre of Infectious and Parasitic DiseasesNational Centre of Infectious and Parasitic DiseasesNational Centre of Infectious and Parasitic Diseases Background: In spite of the use of combination antiretroviral therapy and specific prophylaxis, Pneumocystis pneumonia remains one of the most common AIDS-defining disease with high mortality rate. The aim of this study is to analyze the cases of pneumocystis pneumonia over a three-year period by means of assessing the mortality rate and the prognostic factors for the outcome of the disease.   Material and methods: Epidemiological, clinical, laboratory and demographic data were analyzed for 13 HIV-infected patients with proved pneumocystis pneumonia, hospitalized at the AIDS Department over the period January 2017–December 2019. For data processing we used different methods of descriptive statistics. Results: All presented patients have extremely severe immune deficiency and other opportunistic infections or AIDS-related diseases. The diagnosis of pneumocystis pneumonia was confirmed with PCR in 76.9% of the patients and with Giemsa staining for cysts and trophozoites in 23,1% of the patients. Most of our patients are male (84,6%) and the leading mechanism of HIV infection is unprotected homosexual contact. The mean age of the patients presented is 37.4 ± 10.27. Our results showed high PJP mortality (46.3 %), despite the applied etiological therapy. Conclusions: Pneumocystis jirovecii pneumonia (PJP) continues to be a life-threatening infection in HIV-infected patients with severe immune suppression. PJP mortality continues to be high, and there is a statistically significant dependence on age, male sex, low CD 4 T+ cell count, high viral load of HIV, low blood albumin, and the number and severity of comorbidities. https://pipd.ncipd.org/index.php/pipd/article/view/47Pneumocystis jirovecii pneumoniaprognostic factorsmortality
spellingShingle Nina Yancheva
Dimitar Strashimirov
Maria Nikolova
Ivailo Alexiev
Aleksandra Ivanova
Nina Tsvetkova
Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period
Problems of Infectious and Parasitic Diseases
Pneumocystis jirovecii pneumonia
prognostic factors
mortality
title Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period
title_full Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period
title_fullStr Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period
title_full_unstemmed Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period
title_short Mortality rate and prognostic factors for poor outcome in HIV-infected Bulgarian patients with Pneumocystis pneumonia over a 3-year period
title_sort mortality rate and prognostic factors for poor outcome in hiv infected bulgarian patients with pneumocystis pneumonia over a 3 year period
topic Pneumocystis jirovecii pneumonia
prognostic factors
mortality
url https://pipd.ncipd.org/index.php/pipd/article/view/47
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