title: Pneumocystis jirovecii pneumonia in patients with or without AIDS, France.
abstract: Pneumocystis jirovecii pneumonia (PCP) in patients without AIDS is increasingly common. We conducted a prospective cohort study of consecutive patients with proven PCP; of 544 patients, 223 (41%) had AIDS (AIDS patients) and 321 (59%) had other immunosuppressive disorders (non-AIDS patients). Fewer AIDS than non-AIDS patients required intensive care or ventilation, and the rate of hospital deaths--17.4% overall--was significantly lower for AIDS versus non-AIDS patients (4% vs. 27%; p<0.0001). Multivariable analysis showed the odds of hospital death increased with older age, receipt of allogeneic bone marrow transplant, immediate use of oxygen, need for mechanical ventilation, and longer time to treatment; HIV-positive status or receipt of a solid organ transplant decreased odds for death. PCP is more often fatal in non-AIDS patients, but time to diagnosis affects survival and is longer for non-AIDS patients. Clinicians must maintain a high index of suspicion for PCP in immunocompromised patients who do not have AIDS.
authors.forename: Antoine
authors.initials: A
authors.lastname: Roux
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Canet
authors.forename: Sandrine
authors.initials: S
authors.lastname: Valade
authors.forename: Florence
authors.initials: F
authors.lastname: Gangneux-Robert
authors.forename: Samia
authors.initials: S
authors.lastname: Hamane
authors.forename: Ariane
authors.initials: A
authors.lastname: Lafabrie
authors.forename: Daniéle
authors.initials: D
authors.lastname: Maubon
authors.forename: Anne
authors.initials: A
authors.lastname: Debourgogne
authors.forename: Soléne
authors.initials: S
authors.lastname: Le Gal
authors.forename: Fréderic
authors.initials: F
authors.lastname: Dalle
authors.forename: Marion
authors.initials: M
authors.lastname: Leterrier
authors.forename: Dominique
authors.initials: D
authors.lastname: Toubas
authors.forename: Christelle
authors.initials: C
authors.lastname: Pomares
authors.forename: Anne Pauline
authors.initials: AP
authors.lastname: Bellanger
authors.forename: Julie
authors.initials: J
authors.lastname: Bonhomme
authors.forename: Antoine
authors.initials: A
authors.lastname: Berry
authors.forename: Isabelle
authors.initials: I
authors.lastname: Durand-Joly
authors.forename: Denis
authors.initials: D
authors.lastname: Magne
authors.forename: Denis
authors.initials: D
authors.lastname: Pons
authors.forename: Christophe
authors.initials: C
authors.lastname: Hennequin
authors.forename: Eric
authors.initials: E
authors.lastname: Maury
authors.forename: Patricia
authors.initials: P
authors.lastname: Roux
authors.forename: Élie
authors.initials: É
authors.lastname: Azoulay
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology; D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016017:Odds Ratio; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors