Pneumocystis jirovecii Pneumonia and Human Immunodefi-ciency Virus Co-Infection in Western Iran

  • Arezoo BOZORGOMID Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Yazdan HAMZAVI Department of Medical Parasitology and Mycology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Sahar HEIDARI KHAYAT Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Behzad MAHDAVIAN Department of Infectious Diseases, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
  • Homayoon BASHIRI Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
Keywords: Pneumocystis jirovecii pneumonia; Prevalence; HIV; Iran

Abstract

Abstract

Background: The human immunodeficiency virus (HIV) is one of the greatest health challenges facing worldwide. The virus suppresses the immune system of the patient. The purpose of this study was to describe the epidemiology of Pneumocystis jirovecii colonization, rarely found in normal people, in patients with stage 4 HIV infection in Kermanshah, Iran, from Mar 1995 to Feb 2016.

Methods: In this retrospective study, we surveyed medical records of stage 4 HIV-positive patients with Pneumocystis admitted to Behavioral Counseling Center of Kermanshah. Several parameters were analyzed including demographic characteristics, body mass index (BMI), treatment regimen, diagnostic methods, presenting signs and symptoms, presence of co-pathogens (bacteria, viruses, or fungi), and nadir of CD4 T-cell count before and after treatment.

Results: During the study period, 114 HIV-positive patients were analyzed, of whom 93 were male and 21 were female, respectively. Of 114 cases, 26 (22.8%) patients had Pneumocystis. All 26 colonized patients had CD4 cell counts below 200 cells/mm3 (range 9–186). The median CD4 count increased from 91 cells/mm3 pre- trimethoprim/sulfamethoxazole (TMP/SMX) to an estimated 263 cells/mm3 after starting (TMP/SMX). BMI was normal in the majority of the patients (85%) and coughs, sputum, and chest pain (19; 73%) followed by dyspnea, weakness, and lethargy (7; 27%) were the most common presentations of fungal pneumonia.

Conclusion: HIV/AIDS-infected patients are an environmental reservoir of P. jirovecii infection that might transmit the infection from one person to another via the airborne route. In addition, rapid identification of such individuals may reduce the morbidity and mortality rate of this disease.

 

 

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Published
2019-11-04
How to Cite
1.
BOZORGOMID A, HAMZAVI Y, HEIDARI KHAYAT S, MAHDAVIAN B, BASHIRI H. Pneumocystis jirovecii Pneumonia and Human Immunodefi-ciency Virus Co-Infection in Western Iran. Iran J Public Health. 48(11):2065-2069.
Section
Original Article(s)