2049. Pneumocystis jiroveci Detection by Nested PCR in HIV-Infected Peruvian Patients
Session: Poster Abstract Session: Diagnostics: Mycology
Saturday, October 6, 2018
Room: S Poster Hall
Background: Pneumocystis jiroveci (PJ) is considered a common cause of pneumonia in HIV-AIDS patients. PJ detection now is facilitated by molecular techniques using non-invasive samples; however, there are few PJ colonization studies in HIV population using these techniques. The study aim was to evaluate the frequency and factors related to PJ colonization among HIV-patients with CD4 account < 500 cells/mm3.

Methods: We performed a cross sectional study evaluating HIV patients older than 18 year-old with or without respiratory symptoms with CD4 account < 500 cells/mm3 who attended Hospital Cayetano Heredia in Lima, Peru during May 2017-March 2018. After patients signed an inform consent, clinical information was obtained from the medical chart and a non-induced sputum sample was collected. If patient did not have cough, an oral wash sample using saline was obtained. PJ detection was based on the amplification of the mitochondrial large subunit ribosomal RNA (mtLSU rRNA) in two stages. First, single round PCR was done using external primers (pAZ102E and pAZ102H); then, PCR products were amplified (nested PCR) using internal primers (pAZ102X and pAZ102Y). If the single round PCR was positive in a patient with respiratory symptoms, it was considered a PJ infection. If only the nested PCR was positive, this was considered as PJ colonization.

Results: A total of 177 patients were included, 75 (42.4%) with respiratory symptoms. Three cases were considered PJ infections. A total of 15 cases (8.6%) were colonized by PJ, 7/72 (9.7%) cases with respiratory symptoms and 8/102 (7.8%) among asymptomatic patients. A higher proportion of colonization was seen in patients in whom an oral wash was obtained (14/156, 9.0%) compared to those in whom a non-induced sputum was analyzed (1/18, 5.5%). The frequency of PJ colonization based on CD4 account was 6.5% and 10.3% among patients with <=200 and >200 cells/mm3, respectively.

Conclusion: PJ colonization was seen in 8.6% of HIV patients. The proportion of PJ detection was higher when oral wash was analyzed compared to non-induced sputum. Patients with lower CD4 account did not show a higher proportion of colonization.

Jimmy Camargo, MD1, Beatriz Bustamante, MD1, Edgar Neyra, PhD2, Theresa Ochoa, MD3, Fiorela Alvarez, MD1 and Coralith Garcia, PhD1, (1)Hospital Cayetano Heredia, Lima, Peru, (2)Universidad Peruana Cayetano Heredia, Lima, Peru, (3)University of Texas Health Science Center at Houston, Lima, Peru

Disclosures:

J. Camargo, None

B. Bustamante, None

E. Neyra, None

T. Ochoa, None

F. Alvarez, None

C. Garcia, None

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