Pneumocystis carinii pneumonia in South African children infected with human immunodeficiency virus

Zar, Heather J.; Dechaboon, Anucha; Hanslo, D.; Apolles, Patti; Magnus, Kenneth G.; Hussey, G

doi:10.1097/00006454-200007000-00004

Cited by 91 publications

(78 citation statements)

References 23 publications

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“…[11] LDH has been suggested as a diagnostic test for PCP, with levels >500 IU/L taken as positive evidence. [6] Whilst not all the infants in this study had a LDH >500 IU/L, most did.…”

Section: Discussionmentioning

confidence: 99%

Cytokine profile and clinical correlates in HIV-exposed infants with severe (hypoxic) pneumonia

Green

Terclanche²,

Becker³

et al. 2016

S Afr Res J

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Introduction. Severe pneumonia in infants who are HIV-infected is a common problem in many parts of the developing world, especially sub-Saharan Africa. What has been missing from previous studies of severe pneumonia in HIV-infected infants, however, is a description of the host inflammatory response and cytokine/chemokine profile that accompanies this disease.Objective. To describe the cytokine profiles associated with severe hypoxic pneumonia in HIV-infected infantsMethods. In a cohort of HIV-infected children diagnosed clinically with severe hypoxic pneumonia, paired serum and sputum cytokines were tested. A control group of HIV-infected children with bronchiectasis contributed matching controls.Results. A total of 100 infants (mean age 2.8 months) with a clinical diagnosis of severe hypoxic pneumonia were included in this study. IP-10 was markedly elevated in both sputum (mean 560.77pg/ml) and serum (mean 9091.14pg/ml), while IP-10 was elevated in serum (mean 39.55 pg/ml), with both these cytokines being significantly higher than in stable children with HIV-related bronchiectasis.Conclusion. This study of HIV-infected infants with severe hypoxic pneumonia suggests that IL-10 and IP-10 are associated with more severe lung disease. However, further investigation of this association is required.

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“…[11] LDH has been suggested as a diagnostic test for PCP, with levels >500 IU/L taken as positive evidence. [6] Whilst not all the infants in this study had a LDH >500 IU/L, most did.…”

Section: Discussionmentioning

confidence: 99%

Cytokine profile and clinical correlates in HIV-exposed infants with severe (hypoxic) pneumonia

Green

Terclanche²,

Becker³

et al. 2016

S Afr Res J

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“…However, there was no testing for Pneumocystis jirovecii or Mycobacterium tuberculosis, which would be expected to occur more frequently in HIV-infected children. [28][29][30] There are recent studies that also used molecular techniques to identify viral pathogens in lower respiratory infections (LRTI) in infants in sub-Saharan Africa, although they do not specifically report by infant HIV-infection and feeding strategy . [31][32][33][34][35][36][37][38] Several studies found that RSV was the most frequent pathogen, particularly in infants under 1 year.…”

Section: Discussionmentioning

confidence: 99%

The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding

Zash¹,

Shapiro²,

Leidner³

et al. 2016

Paediatrics and International Child Health

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“…Pneumocystis jirovecii is a significant cause of pneumonia (PCP) in HIV-infected children, especially in the absence of antiretroviral (ARV) therapy or prophylactic treatment (CPT), with high (28-63%) mortality rates [9][10][11][12][13][14][15]. The estimated risk of PCP among perinatally HIV-infected children during the first year of life ranges from 7% to 20% [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

“…Younger age (< 1 year) is associated with increased risk of PCP, especially during the first six months of life [10,[15][16][17][18][20][21][22][23][24]. Studies from Africa reported PCP prevalence rates from 10% to 48.5% among HIV-infected children hospitalized with severe pneumonia [10][11][12]14,15]. Postmortem studies have shown that the prevalence of PCP among HIV-related deaths in children ranged from 11.5% to 52% [18,[25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Antibiotic and systemic therapies for pneumonia in human immunodeficiency virus (HIV)-infected and HIV-exposed children

Punpanich

Groome

Muhe

et al. 2011

J Infect Dev Ctries

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Introduction: Pneumonia is the leading cause of mortality in both human immunodeficiency virus (HIV)-infected and HIV-exposed children. Administration of appropriate empirical antimicrobial and/or adjunctive systemic therapies may improve clinical outcomes. Methodology: To identify effective antimicrobial and/or adjunctive systemic therapy for pneumonia in HIV-infected and HIV-exposed, uninfected children, we searched for published and unpublished studies from 11 databases including MedLine, Global Health Database, Biological Abstracts (BIOSIS), the Cochrane Central Register of Controlled Trials, the World Health Organization Library Information System, AIDSLine, and the System for Information on Grey Literature in Europe, along with additional four regional databases including African Index Medicus, Latin America and Caribbean, Eastern Mediterranean, and South-East Asian databases. Data from full articles of selected studies were independently extracted by two reviewers. Results: No a priori planned randomized controlled trials (RCT) were identified, only subgroup analyses of an RCT comparing oral amoxicillin versus parenteral penicillin for severe pneumonia in children. HIV-infected children had significantly higher treatment failure rates compared to their uninfected counterparts. An RCT study investigating adjunctive corticosteroid therapy for Pneumocystis jiroveci pneumonia (PCP) failed to identify a statistically significant reduction in mortality in the treatment group with a relative risk of 0.57 (95% CI 0.30-1.07). A before-after observational study showed substantial beneficial effect of corticosteroid treatment in reducing mortality among HIV-infected children with PCP. Conclusions: Insufficient evidence exists to identify effective antimicrobial treatment regimens for HIV-associated pneumonia in paediatric populations or confirm the beneficial effect of corticosteroid treatment for HIV-infected children with PCP.

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Pneumocystis carinii pneumonia in South African children infected with human immunodeficiency virus

Abstract: PCP is an important pathogen in HIV-infected infants in South Africa and is associated with a high mortality. Induced sputum is effective for obtaining lower respiratory tract secretions for diagnosis of PCP but an NPA is not useful.

Cited by 91 publications

References 23 publications

Cytokine profile and clinical correlates in HIV-exposed infants with severe (hypoxic) pneumonia

Cytokine profile and clinical correlates in HIV-exposed infants with severe (hypoxic) pneumonia

The aetiology of diarrhoea, pneumonia and respiratory colonization of HIV-exposed infants randomized to breast- or formula-feeding

Antibiotic and systemic therapies for pneumonia in human immunodeficiency virus (HIV)-infected and HIV-exposed children

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