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Processing of Bronchoalveolar Lavage Fluid and Matched Blood for Alveolar Macrophage and CD4+ T-cell Immunophenotyping and HIV Reservoir Assessment
Published on: June 23, 2019
HIV: treating Pneumocystis pneumonia (PCP)
1Department of Infection and Travel Medicine, James Cook University Hospital, Middlesbrough, UK.
BMJ Clinical Evidence
|May 19, 2009
Summary
This systematic review evaluates treatments for Pneumocystis pneumonia (PCP) in HIV-infected individuals. It found various effective interventions, including trimethoprim-sulfamethoxazole (TMP-SMX), but highlights the need for careful consideration of safety and efficacy.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- Pneumocystis pneumonia (PCP) is a significant opportunistic infection in individuals with HIV/AIDS.
- Prophylactic treatments have reduced PCP incidence, but it remains a life-threatening condition without timely intervention.
- Ethical considerations preclude placebo-controlled trials for PCP in AIDS patients.
Purpose of the Study:
- To systematically review the effectiveness of first-line treatments for PCP in HIV-infected individuals.
- To assess the impact of adjuvant corticosteroids on PCP treatment outcomes.
- To evaluate treatment strategies for PCP cases unresponsive to initial therapies.
Main Methods:
- Conducted a systematic literature review up to May 2008.
- Searched major databases including Medline, Embase, and The Cochrane Library.
- Included harms data from regulatory agencies like the FDA and MHRA.
Main Results:
- Identified 22 relevant systematic reviews, RCTs, and observational studies.
- Evaluated the quality of evidence for various interventions using the GRADE system.
- Synthesized data on treatments including TMP-SMX, pentamidine, atovaquone, and others.
Conclusions:
- Presents information on the effectiveness and safety of multiple PCP interventions.
- Key treatments discussed include trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin-primaquine, and atovaquone.
- Addresses management of treatment failures and the role of adjuvant corticosteroids.
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