Non-HIV Patients With Pneumocystis Jiroveci Pneumonia
Conditions
Keywords
Pneumocystis jiroveci, cytomegalovirus, co-infection
Brief summary
PCP (Pneumocystis jiroveci pneumonia) is one of the important opportunistic infections in immunocompromised patients including HIV-infected patients, transplant recipients, and immunosuppressant users. About one third of non-HIV patients with PCP have the evidence of co-infection with CMV. In this difficult clinical situation, physicians have difficulty to decide on whether anti-CMV treament will help patients with any evidence of CMV co-infection. However, there is no objective test to differentiate true co-infection of CMV from innocent bystander of CMV in those with PCP. The investigators thus evaluate the usefulness of CMV-specific ELISPOT assay in patients with PCP to differentiate true co-infection of CMV from inocent bystander of CMV. This findings may guide physicians to decide anti-CMV treatment in patients with PCP and CMV co-infection.
Detailed description
PCP (Pneumocystis jiroveci pneumonia) is one of the important opportunistic infections in immunocompromised patients including HIV-infected patients, transplant recipients, and immunosuppressant users. About one third of non-HIV patients with PCP have the evidence of co-infection with CMV. In this difficult clinical situation, physicians have difficulty to decide on whether anti-CMV treament will help patients with any evidence of CMV co-infection. However, there is no objective test to differentiate true co-infection of CMV from innocent bystander of CMV in those with PCP. The investigators thus evaluate the usefulness of CMV-specific ELISPOT assay in patients with PCP to differentiate true co-infection of CMV from inocent bystander of CMV. This findings may guide physicians to decide anti-CMV treatment in patients with PCP and CMV co-infection.
Interventions
None listed
Sponsors
Asan Medical Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
16 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* diagnosis of PCP based on PCP immunohistochemistry or PCP PCR * age 16 or more * agree with written informed consent * WBC count 2000/uL or more
Exclusion criteria
* HIV infection
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CMV co-infection | 1 month after the diagnosis of PCP | CMV co-infection is defined as (1) positive BAL (bronchoalveolar lavage fluid) CMV culture and (2) ganciclovir therapy for at least 1 week. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| overall mortality | 1 month after the diagnosis of PCP | — |
| innocent bystander CMV infection | 1 month after the diagnosis of PCP | innocent bystander CMV infection * positive blood CMV antigenemia and/or positive blood or BAL CMV qPCR without positive BAL CMV culture * clinical improvement without ganciclovir therapy for at least 1 week |
Countries
South Korea
Outcome results
None listed