1887

Abstract

A retrospective study was performed on case reports of pneumonia (PCP) from 1959 to 2009 in mainland China. The epidemiological characteristics of PCP over half a century were investigated over two time spans. The first was from 1959, when the first incidence of PCP was reported, to 1984, before the emergence of AIDS in mainland China. The second was from 1985, when the first AIDS case was reported in mainland China, to the end of 2009. A total of 2351 PCP cases were reported during these two time spans, covering a 51-year period. Only seven PCP cases were reported during the first time span. Six were diagnosed by autopsy, accordingly without treatment, whilst the other was diagnosed by open lung biopsy in a living patient who eventually recovered following treatment with sulfadiazine and pyrimethamine. The other 2344 PCP cases were reported during the second time span (1985–2009) from 21 provinces, four municipalities and three autonomous regions. Among the 2344 PCP cases, 70.22 % (1646/2344) were identified together with human immunodeficiency virus (HIV) infection or were in AIDS patients. The remaining 698 non-HIV-infected patients had undergone organ transplantation, had other underlying diseases such as malignancy or hypoimmunity, or had undetermined diagnosis. The results of statistical analysis indicated that AIDS was the most common underlying disease of PCP for patients <1 year and >14 years. For patients aged between 1 and 14 years, haematological malignancy was the most common underlying disease. The trend of the underlying diseases changed with time, showing that the number of PCP patients afflicted by HIV/AIDS increased dramatically, reaching almost threefold during the most recent 5 years compared with the level of the previous 10 years. The number of patients undergoing organ transplantation or with other underlying diseases rose constantly, but the number of malignancies tended to decline from 1995–2004 to 2005–2009. During the second time span (1995–2009), most of the patients (97.61 %) were diagnosed alive and only 56 cases (2.39 %) were identified by autopsy. The mortality of PCP patients treated with anti- drugs was 14.61 % for those with HIV/AIDS and 15.84 % for those without HIV/AIDS. For the PCP patients without anti- treatment, all (100 %) of the HIV/AIDS-associated PCP patients died, whilst 13.79 % (4/29) of non-HIV-infected PCP patients survived. These data from epidemiological investigation of PCP in China over a period of half a century may provide useful information for prevention and the development of treatment of PCP.

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2011-05-01
2020-01-25
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References

  1. Abouya Y. L. , Beaumel A. , Lucas S. , Dago-Akribi A. , Coulibaly G. , N’Dhatz M. , Konan J. B. , Yapi A. , De Cock K. M. . ( 1992; ). Pneumocystis carinii pneumonia. An uncommon cause of death in African patients with acquired immunodeficiency syndrome. . Am Rev Respir Dis 145:, 617–620.[PubMed] [CrossRef]
    [Google Scholar]
  2. An C. L. , Tanabe M. . ( 1996; ). Four cases of Pneumocystis carinii pneumonia in Shengyang, Northeast China. . Kisechugaku Zasshi 45:, 512–517.
    [Google Scholar]
  3. Arozullah A. M. , Yarnold P. R. , Weinstein R. A. , Nwadiaro N. , McIlraith T. B. , Chmiel J. S. , Sipler A. M. , Chan C. , Goetz M. B. et al. ( 2000; ). A new preadmission staging system for predicting inpatient mortality from HIV-associated Pneumocystis carinii pneumonia in the early highly active antiretroviral therapy (HAART) era. . Am J Respir Crit Care Med 161:, 1081–1086.[PubMed] [CrossRef]
    [Google Scholar]
  4. Carme B. , Mboussa J. , Andzin M. , Mbouni E. , Mpele P. , Datry A. . ( 1991; ). Pneumocystis carinii is rare in AIDS in Central Africa. . Trans R Soc Trop Med Hyg 85:, 80–85. [CrossRef] [PubMed]
    [Google Scholar]
  5. Chinese Academy of Medical Sciences ( 1959; ). [Two cases of Pneumocystis carinii pneumonia]. . Zhonghua Er Ke Za Zhi 4:, 354 (in Chinese).
    [Google Scholar]
  6. De Castro N. , Pavie J. , Lagrange-Xélot M. , Molina J. M. . ( 2007; ). [Pneumocystis jiroveci pneumonia in patients with cancer: is it unavoidable?]. . Rev Mal Respir 24:, 741–750 (in French).[CrossRef]
    [Google Scholar]
  7. Fisk D. T. , Meshnick S. , Kazanjian P. H. . ( 2003; ). Pneumocystis carinii pneumonia in patients in the developing world who have acquired immunodeficiency syndrome. . Clin Infect Dis 36:, 70–78. [CrossRef] [PubMed]
    [Google Scholar]
  8. Gill B. , Okie S. . ( 2007; ). China and HIV – a window of opportunity. . N Engl J Med 356:, 1801–1805. [CrossRef] [PubMed]
    [Google Scholar]
  9. Ioannidis J. P. , Cappelleri J. C. , Skolnik P. R. , Lau J. , Sacks H. S. . ( 1996; ). A meta-analysis of the relative efficacy and toxicity of Pneumocystis carinii prophylactic regimens. . Arch Intern Med 156:, 177–188. [CrossRef] [PubMed]
    [Google Scholar]
  10. Jia M. , Luo H. , Ma Y. , Wang N. , Smith K. , Mei J. , Lu R. , Lu J. , Fu L. et al. ( 2010; ). The HIV epidemic in Yunnan Province, China, 1989–2007. . J Acquir Immune Defic Syndr 53: Suppl. 1 S34–S40. [CrossRef] [PubMed]
    [Google Scholar]
  11. Kaplan J. E. , Hanson D. L. , Navin T. R. , Jones J. L. . ( 1998; ). Risk factors for primary Pneumocystis carinii pneumonia in human immunodeficiency virus-infected adolescents and adults in the United States: reassessment of indications for chemoprophylaxis. . J Infect Dis 178:, 1126–1132. [CrossRef] [PubMed]
    [Google Scholar]
  12. Kaplan J. E. , Hanson D. , Dworkin M. S. , Frederick T. , Bertolli J. , Lindegren M. L. , Holmberg S. , Jones J. L. . ( 2000; ). Epidemiology of human immunodeficiency virus-associated opportunistic infections in the United States in the era of highly active antiretroviral therapy. . Clin Infect Dis 30: Suppl. 1 S5–S14. [CrossRef] [PubMed]
    [Google Scholar]
  13. Li N. , Wang Z. , Sun D. , Zhu Q. , Sun G. , Yang W. , Wang Q. , Nie Y. , Wu Z. . ( 2010; ). HIV among plasma donors and other high-risk groups in Henan, China. . J Acquir Immune Defic Syndr 53: Suppl. 1 S41–S47. [CrossRef] [PubMed]
    [Google Scholar]
  14. Lian Y. L. , Heng B. S. , Nissapatorn V. , Lee C. . ( 2007; ). AIDS-defining illnesses: a comparison between before and after commencement of highly active antiretroviral therapy (HAART). . Curr HIV Res 5:, 484–489. [CrossRef] [PubMed]
    [Google Scholar]
  15. Machiels G. , Urban M. I. . ( 1992; ). Pneumocystis carinii as a cause of pneumonia in HIV-infected patients in Lusaka, Zambia. . Trans R Soc Trop Med Hyg 86:, 399–400. [CrossRef] [PubMed]
    [Google Scholar]
  16. Morris A. . ( 2008; ). Is there anything new in Pneumocystis jirovecii pneumonia? Changes in P. jirovecii pneumonia over the course of the AIDS epidemic. . Clin Infect Dis 46:, 634–636. [CrossRef] [PubMed]
    [Google Scholar]
  17. Morris A. , Wachter R. M. , Luce J. , Turner J. , Huang L. . ( 2003; ). Improved survival with highly active antiretroviral therapy in HIV-infected patients with severe Pneumocystis carinii pneumonia. . AIDS 17:, 73–80. [CrossRef] [PubMed]
    [Google Scholar]
  18. Morris A. , Lundgren J. D. , Masur H. , Walzer P. D. , Hanson D. L. , Frederick T. , Huang L. , Beard C. B. , Kaplan J. E. . ( 2004; ). Current epidemiology of Pneumocystis pneumonia. . Emerg Infect Dis 10:, 1713–1720.[PubMed] [CrossRef]
    [Google Scholar]
  19. Radhi S. , Alexander T. , Ukwu M. , Saleh S. , Morris A. . ( 2008; ). Outcome of HIV-associated Pneumocystis pneumonia in hospitalized patients from 2000 through 2003. . BMC Infect Dis 8:, 118–127. [CrossRef] [PubMed]
    [Google Scholar]
  20. Roblot F. , Godet C. , Le Moal G. , Garo B. , Faouzi Souala M. , Dary M. , De Gentile L. , Gandji J. A. , Guimard Y. et al. ( 2002; ). Analysis of underlying diseases and prognosis factors associated with Pneumocystis carinii pneumonia in immunocompromised HIV-negative patients. . Eur J Clin Microbiol Infect Dis 21:, 523–531.[CrossRef]
    [Google Scholar]
  21. Sheng L. , Cao W. K. . ( 2008; ). HIV/AIDS epidemiology and prevention in China. . Chin Med J (Engl) 121:, 1230–1236.[PubMed]
    [Google Scholar]
  22. Walzer P. D. , Evans H. E. , Copas A. J. , Edwards S. G. , Grant A. D. , Miller R. F. . ( 2008; ). Early predictors of mortality from Pneumocystis jirovecii pneumonia in HIV-infected patients: 1985–2006. . Clin Infect Dis 46:, 625–633. [CrossRef] [PubMed]
    [Google Scholar]
  23. Wang N. . ( 2007; ). [The epidemic character of AIDS in China]. . Infect Dis Info 20:, 325–326 (in Chinese).
    [Google Scholar]
  24. Xu Z. Y. , Weng X. H. , Guo M. Y. , Ying Y. Y. , Wang G. X. , Huang M. Y. , Dai Z. Y. . ( 1979; ). [One case report of renal transplant recipient co-infected with Pneumocystis, Cytomegalovirus and Aspergillus]. . Chin J Integr Med 18:, 293–295 (in Chinese).
    [Google Scholar]
  25. Yang S. Y. , Li X. Q. , Zhu M. Z. , Wang Q. S. . ( 1987; ). [Sixteen acute leukemia cases complicated with PCP during the paracmasis of the leukaemia]. . Zhonghua Er Ke Za Zhi 25:, 264–267 (in Chinese).
    [Google Scholar]
  26. Yin N. , Mei S. , Li L. , Wei F. L. , Zhang L. Q. , Cao Y. Z. . ( 2003; ). [Study on the epidemiology and distribution of human immunodeficiency virus-1 and hepatitis C virus infection among intravenous drug users and illegal blood donors in China]. . Zhonghua Liu Xing Bing Xue Za Zhi 24:, 962–965 (in Chinese).[PubMed]
    [Google Scholar]
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