No Statistically Apparent Difference in Antifungal Effectiveness Observed Among Trimethoprim/Sulfamethoxazole Plus Clindamycin or Caspofungin, and Trimethoprim/Sulfamethoxazole Monotherapy in HIV-Infected Patients with Moderate to Severe Pneumocystis Pneumonia: Results of an Observational Multicenter Cohort Study

Huang, Yin-Qiu; He, Xiaoqing; Chen, Hui; Harypursat, Vijay; Lu, Yanqiu; Yuan, Jing; Nie, Jingmin; Liu, Min; Yu, Jianhua; Zhang, Yulin; Jiang, Zhuocheng; Qin, Yingmei; Xu, Lijun; Zhou, Guoqiang; Zhang, Defa; Chen, Xiaohong; Zheng, Baisong; Chen, Yaokai

doi:10.1007/s40121-021-00586-5

Cited by 6 publications

(7 citation statements)

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“…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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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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“…1,2 Severe cases can develop respiratory failure and even die. 3,4 It initially attracted attention among human immunodeficiency virus (HIV) patients, 5 then in solid organ transplantation recipients, haematopoietic stem cell transplantation patients, and those who received corticosteroids and chemotherapy drugs. 6 PJP often occurs in patients after solid organ transplantation such as kidney transplantation.…”

Section: Introductionmentioning

confidence: 99%

“…Pneumocystis jirovecii pneumonia (PJP), an opportunistic infection that is sometimes life‐threatening, often occurs in individuals with impaired immunity 1,2 . Severe cases can develop respiratory failure and even die 3,4 . It initially attracted attention among human immunodeficiency virus (HIV) patients, 5 then in solid organ transplantation recipients, haematopoietic stem cell transplantation patients, and those who received corticosteroids and chemotherapy drugs 6 …”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics and risk factors for late‐onset pneumocystis jirovecii pneumonia in kidney transplantation recipients

Zhu,

Xie,

Fan

et al. 2024

Mycoses

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BackgroundPneumocystis jirovecii pneumonia (PJP) is a common and troublesome complication of kidney transplantation. In the era of prophylaxis, the peak incidence of PJP after kidney transplantation and specific characteristics of late‐onset PJP have always been debated.MethodsWe performed a retrospective study by analysing the data of post‐transplantation pneumonia in adult kidney transplantation recipients between March 2014 and December 2021 in The Affiliated First Hospital of University of Science and Technology of China (USTC). A total of 361 patients were included and divided into early‐onset PJP, late‐onset PJP and non‐PJP groups. The characteristics of each group and related risk factors for the late‐onset patients were investigated.ResultsSome patients developed PJP 9 months later with a second higher occurrence between month 10 and 15 after transplantation. Compared with non‐PJP, ABO‐incompatible and cytomegalovirus (CMV) viremia were significantly associated with late onset of PJP in multivariate analysis. The use of tacrolimus, CMV viremia, elevated CD8(+) T cell percent and hypoalbuminemia were risk factors for late PJP. Receiver operating characteristic curve analysis demonstrated that a combination of those factors could increase the sensitivity of prediction remarkably, with an area under the curve of 0.82, a sensitivity of 80% and a specificity of 83%.ConclusionsPJP could occur months after kidney transplantation. ABO‐incompatible transplant recipients are at high risk of PJP. In the later stages of transplantation, CMV viremia, T lymphocyte subsets percentage and serum albumin levels should be monitored in patients using tacrolimus.

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“…However, the clinical application of TMP/SMZ is associated with various side-effects [7]. One of the promising approaches to improving the therapeutic efficacy of drugs and reducing their side-effects is the loading of drugs into nanoparticles [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

A PEGylated Nanostructured Lipid Carrier for Enhanced Oral Delivery of Antibiotics

et al. 2022

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Antimicrobial resistance is a major concern for public health throughout the world that severely restricts available treatments. In this context, methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a high percentage of S. aureus infections and mortality. To overcome this challenge, nanoparticles are appropriate tools as drug carriers to improve the therapeutic efficacy and decrease the toxicity of drugs. In this study, a polyethylene glycol (PEG)ylated nanostructured lipid carrier (PEG-NLC) was synthesized to improve the oral delivery of trimethoprim/sulfamethoxazole (TMP/SMZ) for the treatment of MRSA skin infection in vitro and in vivo. The nanoformulation (PEG-TMP/SMZ-NLC) was synthesized with size and drug encapsulation efficiencies of 187 ± 9 nm and 93.3%, respectively, which could release the drugs in a controlled manner at intestinal pH. PEG-TMP/SMZ-NLC was found efficient in decreasing the drugs’ toxicity by 2.4-fold in vitro. In addition, the intestinal permeability of TMP/SMZ was enhanced by 54%, and the antibacterial effects of the drugs were enhanced by 8-fold in vitro. The results of the stability study demonstrated that PEG-TMP/SMZ-NLC was stable for three months. In addition, the results demonstrated that PEG-TMP/SMZ-NLC after oral administration could decrease the drugs’ side-effects such as renal and hepatic toxicity by ~5-fold in MRSA skin infection in Balb/c mice, while it could improve the antibacterial effects of TMP/SMZ by 3 orders of magnitude. Overall, the results of this study suggest that the application of PEGylated NLC nanoparticles is a promising approach to improving the oral delivery of TMP/SMZ for the treatment of MRSA skin infection.

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Cited by 6 publications

References 16 publications

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

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

Clinical characteristics and risk factors for late‐onset pneumocystis jirovecii pneumonia in kidney transplantation recipients

A PEGylated Nanostructured Lipid Carrier for Enhanced Oral Delivery of Antibiotics

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