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Pneumocystis carinii pneumonia in Hong Kong: a 10 year retrospective study

M Hui1, W T Kwok1

  • 1Department of Microbiology, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong SAR.

Journal of Medical Microbiology
|January 3, 2006
PubMed

Insights

Pneumocystis pneumonia (PCP) affects both HIV-infected and non-HIV patients with immunosuppressive conditions. Despite treatment, PCP has a high mortality rate, suggesting a need for chemoprophylaxis in at-risk individuals.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Pulmonology

Background:

  • Pneumocystis pneumonia (PCP) is an opportunistic infection primarily associated with human immunodeficiency virus (HIV) infection.
  • However, PCP can also occur in non-HIV individuals undergoing immunosuppressive therapies or with underlying conditions.
  • Understanding the epidemiology and outcomes of PCP in diverse patient groups is crucial for clinical management.

Purpose of the Study:

  • To review the clinical characteristics and outcomes of Pneumocystis pneumonia (PCP) in both HIV-infected and non-HIV-infected patients.
  • To identify underlying conditions and therapies associated with PCP in non-HIV patients.
  • To assess the treatment response and mortality rates of PCP in this cohort.

Main Methods:

  • A retrospective review of patients diagnosed with PCP between 1994 and 2003 at Prince of Wales Hospital, Hong Kong.
  • Data collected included patient demographics, HIV status, underlying diseases, co-infections, treatment regimens, adverse events, and mortality.
  • Statistical analysis was performed to describe the characteristics and outcomes of the patient cohort.

Main Results:

  • Eighteen patients were diagnosed with PCP; 6 (33.3%) were HIV-infected.
  • Twelve non-HIV patients had various underlying conditions, including post-renal transplant, hematological malignancies, autoimmune diseases, renal diseases, hepatocellular carcinoma, and congenital cytomegalovirus disease.
  • Cytomegalovirus co-infection occurred in four patients. Crude mortality was 33.3% despite cotrimoxazole therapy, with notable intolerance in four patients.

Conclusions:

  • Pneumocystis pneumonia (PCP) is not exclusive to HIV-infected individuals and frequently occurs in patients with various immunosuppressive conditions and therapies.
  • The high mortality rate observed, even with appropriate treatment, underscores the severity of PCP.
  • Consideration of chemoprophylaxis is recommended for populations identified as being at increased risk for PCP.

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