441. Clinical Characteristics of Pneumocystis jirovecii Pneumonia with Pulmonary Cystic Lesions in HIV Patients
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Background:  There is limited data about the characteristics and prognosis of Pneumocystis jirovecii pneumonia (PCP) with pulmonary cystic lesions in HIV patients.

Methods:  All HIV patients with PCP were identified from 1999 to 2011 at a tertiary care hospital (South Korea). The cases who underwent chest computerized tomography (CT) scans at diagnosis were classified into cystic and non-cystic groups based on the CT findings. A cyst was defined by any thin-walled, gas-containing pulmonary space.

Results:  Of 116 HIV-infected patients with PCP, chest CT scans were performed in 98 patients; cystic group (n=32) or non-cystic group (n=66). Patients in the cystic group were older and had a longer smoking history than those in the non-cystic group, while baseline CD4 cell counts and symptom duration before visit to clinic were comparable between groups (Table). In the cystic group, pneumothorax occurred more frequently and in-hospital mortality rates were higher than in non-cystic group (p=0.002, p=0.028, respectively).

Conclusion: Pulmonary cystic lesions at CT scans suggest the poor outcome in HIV patients with PCP.

Table. Clinical characteristics in HIV patients with cystic or non-cystic PCP

Variables

 Cystic PCP(n=32)

 Non-cystic PCP (n=66)

 p value

Age(yrs)

45±12

40±9

0.016

Male sex(%)

31(97)

60(91)

0.421

Symptom duration before visit to clinic (days)

38±37

27±29

0.156

Smoking(PY)

12±12

5±9

0.019

CD4 cell count (/µL)

69±132

34±42

0.142

Viral load(Log10copies/mL)

4±2

5±1

0.098

PaO2(mmHg)

72±25

68±20

0.411

A-aDO2(mmHg)

148±161

87±79

0.056

Pneumothorax(%)

9(28)

3(5)

0.002

Mortality (%)

9(28)

7(11)

0.028


Subject Category: H. HIV/AIDS and other retroviruses

Yu Min Kang, MD1, Pyoeng Gyun Choe, MD2, Kyoung-Ho Song, MD1, Eu Suk Kim, MD, PhD1, Hong Bin Kim, MD, PhD1, Nam-Joong Kim, MD2, Wan Beom Park, MD, PhD2 and Myoung-don Oh, MD, PhD1, (1)Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea, (2)Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea

Disclosures:

Y. M. Kang, None

P. G. Choe, None

K. H. Song, None

E. S. Kim, None

H. B. Kim, None

N. J. Kim, None

W. B. Park, None

M. D. Oh, None

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