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

Authors

  • Nina Yancheva Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases
  • Dimitar Strashimirov Specialized Hospital for Active Treatment of Infectious and Parasitic Diseases “Prof. Ivan Kirov”
  • Prof. Maria Nikolova National Centre of Infectious and Parasitic Diseases
  • Ivailo Alexiev National Centre of Infectious and Parasitic Diseases
  • Aleksandra Ivanova National Centre of Infectious and Parasitic Diseases
  • Nina Tsvetkova National Centre of Infectious and Parasitic Diseases

Keywords:

Pneumocystis jirovecii pneumonia, prognostic factors, mortality

Abstract

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.

Author Biographies

Prof. Maria Nikolova, National Centre of Infectious and Parasitic Diseases

Head of departement of Immunology

Ivailo Alexiev, National Centre of Infectious and Parasitic Diseases

Head of NRCL HIV

Aleksandra Ivanova, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory for Diagnosis of Parasitic Diseases

Nina Tsvetkova, National Centre of Infectious and Parasitic Diseases

National Reference Laboratory for Diagnosis of Parasitic Diseases

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Published

2020-12-17

How to Cite

Yancheva, N., Strashimirov, D., Nikolova, M., Alexiev, I., Ivanova, A., & Tsvetkova, N. (2020). 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, 48(3), 16–20. Retrieved from https://pipd.ncipd.org/index.php/pipd/article/view/48-3-2_mortality_rate_and_prognostic_factors

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