Genetic Polymorphisms of Pneumocystis jirovecii in HIV-Positive and HIV-Negative Patients in Northern China

Xue, Ting; Du, Wei-Qin; Dai, Wenjuan; Li, Yi-Shan; Wang, Shufeng; Wang, Junling; Zhang, Xinri

doi:10.33073/pjm-2022-002

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…It is similar to the studies that have shown specific genotypes of Pneumocystis have strong correlation with the underlying diseases or conditions of the human host that caused the immunocompromised status [40]. Additionally, various genotypes of Pneumocystis based on the status of HIV infection itself and/or the underlying health conditions, including any combined complications, in people living with HIV have been reported, supporting genetic epidemics of Pneumocystis [41][42][43]. Although the genetic epidemics of Pneumocystis may not be representative of a link with PcP incidence, it may be helpful in predicting PcP occurrence in Korea.…”

Section: Discussionsupporting

confidence: 83%

Spatiotemporal Clusters and Trends of Pneumocystis Pneumonia in Korea

Kim

Nam²,

Ahn³

et al. 2022

Korean J Parasitol

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This study determined the recent status and trend of Pneumocystis jirovecii pneumonia (PcP) in the non-human immunodeficiency virus (HIV) (non-HIV-PcP) and HIV (HIV-PcP) infected populations using data from the Health Insurance Review & Assessment Service (HIRA) and the Korea Disease Control and Prevention Agency (KDCA). SaTScan and Joinpoint were used for statistical analyses. Non-HIV-PcP cases showed an upward trend during the study period from 2010 to 2021, with the largest number in 2021 (551 cases). The upward trend was similar until 2020 after adjusting for the population. Seoul had the highest number of cases (1,597) in the non-HIV-PcP group, which was the same after adjusting for the population (162 cases/1,000,000). It was followed by Jeju-do (89 cases/1,000,000). The most likely cluster (MLC) for the non-HIV-PCP group was Seoul (Relative Risk (RR)=4.59, Log Likelihood Ratio (LLR)=825.531), followed by Jeju-do (RR=1.59, LLR=5.431). An upward trend was observed among the non-HIV-PcP group in the Jeju-do/Jeollanam-do/Jeollabuk-do/Gyeongsangnam-do/Busan/Daejeon/Daegu/Ulsan joint cluster (29.02%, LLR=11.638, P<0.001) located in the southern part of Korea. Both women and men in the non-HIV groups showed an overall upward trend of PcP during the study period. Men in the 60-69 age group had the highest annual percentage change (APC 41.8) during 2014-2019. In contrast, the HIV groups showed a falling trend of PcP recently. Men in the 60-69 age group had the most decrease (APC -17.6) during 2018-2021. This study provides an analytic basis for health measures and a nationwide epidemiological surveillance system for the management of PcP.

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Section: Discussionsupporting

confidence: 83%

Spatiotemporal Clusters and Trends of Pneumocystis Pneumonia in Korea

Kim

Nam²,

Ahn³

et al. 2022

Korean J Parasitol

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“…In eleventen studies [ 54 , 55 , 57 , 60 , 61 , 65 , 87 , 88 , 90 , 91 ], including 670 PCP cases among 1272 HIV-positive patients, death events were recorded in 124 and 210 cases, respectively. The results of our OR analysis indicated that the mortality rate increased by 52% in HAP patients (OR:1.522; 95% CI:0.959 to 2.416; I 2 : 53.8%; P = 0.022)( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…The results of the OR analysis of patient gender captured from six studies [ 48 , 60 , 62 , 74 , 76 , 82 ] indicated that HIV-positive men had a 7% higher chance rate for PCP compared to women (OR:1.073; 95% CI:0.674 to 1.706; I 2 : 0%; P = 0.959)( Table 2 ). The results of standard mean difference (SMD) analysis of patient’s age captured from twenty-one studies [ 40 , 41 , 44 , 48 , 49 , 53 , 55 , 56 , 58 , 59 , 61 – 65 , 74 , 77 , 82 , 88 , 91 , 92 ], including 1583 PCP patients among 2044 HIV-positive cases, indicated that there is no significant difference between HIV/AIDS patients with PCP and without PCP (SMD: -0.140; 95% CI:-0.315 to -0.034; I 2 : 78.6%;P = 0.000).…”

Section: Resultsmentioning

confidence: 99%

“…Our random effect models for SMD analysis of serum levels of CD4 + T cells [ 43 , 49 , 55 , 56 , 58 – 62 , 74 , 88 , 91 , 92 ], LDH [ 48 , 55 , 64 , 65 , 88 ], and BDG [ 45 , 55 , 59 , 64 , 92 ] in 12, 5, and 5 studies (respectively), indicated that serum levels of CD4 + T cells (SMD: -0.617; 95% CI:-1.122 to -0.111; I 2 : 95.1%;P = 0.000) and LDH (SMD: -0.089; 95% CI:-0.089 to 0.267; I 2 : 8.2%;P = 0.36) did not differ statistically between HIV/PCP-positive and HIV-positive PCP-negative patients. However, the mean serum and/or BAL levels of BDG of HIV/PCP-positive patients were higher than HIV-positive PCP-negatives (SMD: 2.664; 95% CI:1.110 to 4.217; I 2 : 97.7%;P = 0.000)( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

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Global prevalence, mortality, and main characteristics of HIV-associated pneumocystosis: A systematic review and meta-analysis

Ahmadpour,

Valilou,

Ghanizadegan

et al. 2024

PLoS ONE

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The epidemiology of Human Immunodeficiency Virus (HIV)-associated pneumocystosis (HAP) is poorly described on a worldwide scale. We searched related databases between January 2000 and December 2022 for studies reporting HAP. Meta-analysis was performed using StatsDirect (version 2.7.9) and STATA (version 17) according to the random-effects model for DerSimonian and Laird method and metan and metaprop commands, respectively. Twenty-nine studies with 38554 HIV-positive, 79893 HIV-negative, and 4044 HAP populations were included. The pooled prevalence of HAP was 35.4% (95% CI 23.8 to 47.9). In contrast, the pooled prevalence of PCP among HIV-negative patients was 10.16% (95% CI 2 to 25.3). HIV-positive patients are almost 12 times more susceptible to PCP than the HIV-negative population (OR: 11.710; 95% CI: 5.420 to 25.297). The mortality among HAP patients was 52% higher than non-PCP patients (OR 1.522; 95% CI 0.959 to 2.416). HIV-positive men had a 7% higher chance rate for PCP than women (OR 1.073; 95% CI 0.674 to 1.706). Prophylactic (OR: 6.191; 95% CI: 0.945 to 40.545) and antiretroviral therapy (OR 3.356; 95% CI 0.785 to 14.349) were used in HAP patients six and three times more than HIV-positive PCP-negatives, respectively. The control and management strategies should revise and updated by health policy-makers on a worldwide scale. Finally, for better management and understanding of the epidemiology and characteristics of this coinfection, designing further studies is recommended.

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“…However, single-strand cultures were not the goal of this study—our aim was simply to establish a stable culture at all. A single patient often harbors more than one strain of P. jirovecii at the same time [ 6 , 66 , 67 , 68 ], so the idea of a “single-strain” culture is specious anyway. Therefore, we used mixed P. jirovecii strains from 3 to 4 BALF samples, which stabilized the system and ensured growth in this first attempt, which resulted in 41 successful flask cultures.…”

Section: Discussionmentioning

confidence: 99%

Axenic Long-Term Cultivation of Pneumocystis jirovecii

Riebold,

Mahnkopf,

Wicht

et al. 2023

JoF

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Pneumocystis jirovecii, a fungus causing severe Pneumocystis pneumonia (PCP) in humans, has long been described as non-culturable. Only isolated short-term experiments with P. jirovecii and a small number of experiments involving animal-derived Pneumocystis species have been published to date. However, P. jirovecii culture conditions may differ significantly from those of animal-derived Pneumocystis, as there are major genotypic and phenotypic differences between them. Establishing a well-performing P. jirovecii cultivation is crucial to understanding PCP and its pathophysiological processes. The aim of this study, therefore, was to develop an axenic culture for Pneumocystis jirovecii. To identify promising approaches for cultivation, a literature survey encompassing animal-derived Pneumocystis cultures was carried out. The variables identified, such as incubation time, pH value, vitamins, amino acids, and other components, were trialed and adjusted to find the optimum conditions for P. jirovecii culture. This allowed us to develop a medium that produced a 42.6-fold increase in P. jirovecii qPCR copy numbers after a 48-day culture. Growth was confirmed microscopically by the increasing number and size of actively growing Pneumocystis clusters in the final medium, DMEM-O3. P. jirovecii doubling time was 8.9 days (range 6.9 to 13.6 days). In conclusion, we successfully cultivated P. jirovecii under optimized cell-free conditions in a 70-day long-term culture for the first time. However, further optimization of the culture conditions for this slow grower is indispensable.

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Genetic Polymorphisms of Pneumocystis jirovecii in HIV-Positive and HIV-Negative Patients in Northern China

Cited by 3 publications

References 33 publications

Spatiotemporal Clusters and Trends of Pneumocystis Pneumonia in Korea

Spatiotemporal Clusters and Trends of Pneumocystis Pneumonia in Korea

Global prevalence, mortality, and main characteristics of HIV-associated pneumocystosis: A systematic review and meta-analysis

Axenic Long-Term Cultivation of Pneumocystis jirovecii

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