SESSION TITLE: AIDS/ Immunocompromised Patients Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Pneumocystis jirovecii pneumonitis is a serious opportunistic infection in HIV positive patients. Prior studies on outcomes of PJP patients were done over a decade. We examined the outcomes of HIV patients with PJP in the current era.
METHODS: Between January 2007 and August 2012, 119 HIV positive patients were discharged with primary or secondary discharge diagnoses of PJP based on International Classification of Disease (ICD)-9 codes 042 and 1363. We included patients with a confirmed PJP infection by sputum and/or BAL cytology. Data on baseline demographics, HIV viral load, CD-4 count, LDH levels, ICU admission, and receipt of mechanical ventilation, treatment with steroids, hepatitis-C co-infection, and presence of pneumothorax were recorded. A positive case of CMV was defined as any positive serological or BAL fluid by shell vial cultures, PCR, CMV IgG and/or IgM antibodies. Our primary outcome was in-hospital mortality. Descriptive statistics were presented as proportions and percents. T-test and chi square is used to compare continuous and categorical data, respectively. A p-value of<0.05 is consider statistical significant.
RESULTS: Fifty-seven patients had a confirmed diagnosis of PJP. All cause in-hospital mortality rate was 19%.There was no difference in CD-4 count, HIV viral load, total leukocytic count, serum LDH levels, HCV co-infection in those who died vs. those who survived. 18 patients (31%) had CMV co-infection. Patients with CMV co-infection had a higher mortality (27% vs.15%). Patients who died were more likely to have had respiratory failure and require mechanical ventilation.
CONCLUSIONS: Overall mortality among HIV positive patients with PJP pneumonitis remains high.
CLINICAL IMPLICATIONS: 1-Even after more than a decade,mortality from PJP pneumonitis in HIV patients remains high 2-Patients with CMV co-infection had a higher mortality (27% vs.15%), although not statistically significant
DISCLOSURE: The following authors have nothing to disclose: Ragai Meena, Gulshan Sharma, George Samuel
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