Clinical and experimental rheumatology · 2018
Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and inflammatory diseases.
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Baulier Gildas, Issa Nahema, Gabriel Frederic, Accoceberry Isabelle, Camou Fabrice, Duffau Pierre
Аннотация
OBJECTIVES: Guidelines for preventing Pneumocystis pneumonia (PCP) in HIV patients are based on CD4 below 200/mm3. Such cut-off value is suggested to guide prophylaxis in non-HIV conditions (NHIV) especially in autoimmune and inflammatory diseases (AD). We aimed to determine if CD4 could be used to guide PCP prophylaxis in AD.
METHODS: CD4 and lymphocyte-count were retrospectively studied in patients diagnosed with PCP between January 2013 and February 2016.
RESULTS: 129 patients were included. The median CD4-count was 302/mm3 in AD, which was significantly higher than in HIV patients (19/mm3; p<0.0001). Fifty percent (n=10) of AD patients had CD4 counts greater than 300/mm3.
CONCLUSIONS: Prophylaxis for PCP cannot rely solely on CD4-count in NHIV patients especially in AD.
METHODS: CD4 and lymphocyte-count were retrospectively studied in patients diagnosed with PCP between January 2013 and February 2016.
RESULTS: 129 patients were included. The median CD4-count was 302/mm3 in AD, which was significantly higher than in HIV patients (19/mm3; p<0.0001). Fifty percent (n=10) of AD patients had CD4 counts greater than 300/mm3.
CONCLUSIONS: Prophylaxis for PCP cannot rely solely on CD4-count in NHIV patients especially in AD.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAnti-Neutrophil Cytoplasmic Antibody-Associated VasculitisArthritis, RheumatoidAutoimmune DiseasesCD4 Lymphocyte CountCD4-Positive T-LymphocytesCryoglobulinemiaDermatomyositisDisease ManagementFemaleGiant Cell ArteritisHIV InfectionsHepatitis, AutoimmuneHumansImmunocompromised HostImmunosuppressive AgentsLymphopeniaMaleMiddle AgedNeoplasmsOrgan TransplantationPneumonia, PneumocystisPractice Guidelines as TopicRetrospective Studies