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Pneumocystis carinii pneumonia in HIV infected patients from Mumbai

Z F Udwadia1, Amita V Doshi, Anita S Bhaduri

  • 1Department of Chest Medicine, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai 400016.

The Journal of the Association of Physicians of India
|August 30, 2005
PubMed
Abstract

Insights

Pneumocystis pneumonia (PCP) is a significant pulmonary disease in Indian patients with advanced HIV, often underdiagnosed. This study highlights its prevalence and high mortality, emphasizing the need for increased recognition.

Area of Science:

  • Infectious Diseases
  • Pulmonology
  • HIV Medicine

Background:

  • Pneumocystis pneumonia (PCP) is considered rare in developing nations, with limited prospective data from India.
  • No large prospective Indian series on PCP in HIV-infected individuals have been previously reported.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of PCP in HIV-infected patients in India.
  • To assess the prevalence and diagnostic challenges of PCP in a tertiary care setting.

Main Methods:

  • A prospective study of HIV-positive patients diagnosed with PCP over four years (2000-2003) at a Mumbai tertiary referral center.
  • Data collection included patient demographics, CD4 counts, diagnostic methods (including bronchoscopy), co-infections, and mortality.

Main Results:

  • 38 cases of PCP were identified among 300 HIV admissions (12.7%).
  • PCP predominantly affected males (M:F ratio 5.4:1) with a median CD4 count of 96 cells/microL.
  • Mortality was high at 15.8%, with all mechanically ventilated patients dying. PCP co-occurred with tuberculosis in 4 patients.

Conclusions:

  • PCP is a common opportunistic infection in Indian patients with advanced HIV, frequently overlooked.
  • PCP was the second most common pulmonary disease in hospitalized HIV patients, following tuberculosis.
  • Improved recognition and diagnostic strategies are crucial for managing PCP in this population.

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