The Internet Book of Critical Care Podcast IBCC Episode 121 - Pneumocystis Jiroveci Pneumonia
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Feb 21, 2022 AI Snips
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Different Immune Responses in HIV Status
- HIV-positive patients with Pneumocystis jiroveci pneumonia (PJP) typically have a higher pathogen burden but mount a weaker immune response.
- HIV-negative patients mount stronger immune responses, often resulting in more acute, fulminant illness and worse outcomes.
Changing Epidemiology of PJP in HIV
- PJP is now mainly seen in HIV patients unaware of their status or not adhering to treatment.
- Highly active antiretroviral therapy has greatly reduced PJP incidence in well-controlled HIV patients.
Steroid and Immunosuppression Risks for PJP
- Chronic steroid use (>15 mg prednisone >2 months) is the leading cause of PJP in HIV-negative patients.
- Risk depends on context, with malignancy, rheumatologic disease, and transplant status increasing susceptibility.