Burden, mortality, and associated factors of Pneumocystis jerovesi pneumonia among human immunodeficiency virus/AIDS patients: Systematic review and meta-analysis

Abstract

Pneumocystis pneumonia has classically been described as a serious complication in human immunodeficiency virus (HIV) infected patients caused by Pneumocystis Jirovecii pneumonia formerly called Pneumocystis Carinii Pneumonia (PJP). During the early period of the Acquire Immunodeficiency Syndrome (AIDS) epidemic, PJP was recognized as one of the AIDS-defining illnesses for as many as two-thirds of patients in the United States. Despite the introduction of combination antiretroviral therapy for the human immunodeficiency virus (HIV), PJP remains one of the leading causes of morbidity and mortality. The aim of the present study was to review existing literature on the burden, a mortality rate of PJP among HIV/AIDS patients and its associated factors. A total of 65 studies were eligible and included in this review. A meta-analysis by random effect model showed that the estimated pooled prevalence of PJP 15% (38,881/293,239; 95% confidence interval [CI]: 12%–21%). According to pooled estimates of this study, the overall mortality rate of PJP among HIV/AIDS patients was about 25% We demonstrated that CD4 level was significantly related to PJP infection, where the highest risk patients are those with CD4 count <200 cells/μl (odds ratio: 1.81, 95% CI: 1.22–2.69, P < 0.01). According to the pooled estimates of this study, PJP among HIV/AIDS patients was the cause of a high rate of morbidity and mortality.

Keywords

• acquired immunodeficiency syndrome
• pneumocystis carinii pneumonia
• pneumocystis jirovecii pneumonia