Pneumocystis jirovecii colonisation in young people with HIV infection
Abstract number: P1584
Morilla R., Montes-Cano M., Leon Leal J., Rivero L., Friaza V., Respaldiza N., Martin I., Gutierrez-Rivero S., Solano P., Medrano J., Varela J., Calderon E., de la Horra C.
Objectives: The incidence of Pneumocystis pneumonia (PcP) has declined in AIDS patients in developed countries with the use of specific chemoprophylaxis and highly active antiretroviral therapy (HAART), but still being the major cause of morbidity and mortality. The use of molecular techniques for diagnosis has revealed the existence of both: immunosuppressed and immunocompetent carriers of Pneumocystis. The colonisation in subjects with HIV infection is a risk for developing PcP. In our environment there is not information about this situation. The aim was to investigate the frequency of colonisation by P. jirovecii in young subjects with HIV infection and risk factors associated to this colonisation.
Patients and Methods: Twenty patients followed since childhoods were included and their clinical, immunological stage and viral load was analysed. To determine the presence of P. jirovecii sputum and/or oral wash samples was obtained in a follow-up visit. PCR techniques were assayed at two independent loci: The mitochondrial region (mt LSU rRNA) and DHPS gene (mutations are associated with sulphonamides resistance). These mutations were identified by restriction analysis of polymorphisms (RLFP).
Results: The mean age of cohort was 13.7 years, being 11 of them male. In 10% a previous PcP episode was diagnosed. The rate of colonisation by P Jirovecii at the moment of the study was 40% (8/20). None of these patients shows mutations at DHPS gene. Statistical analysis does not shown relationship between the presence and absence of colonisation and, CD4+, CD8+ levels, or viral load.
Conclusions: There is a high rate of colonisation by Pneumocystis in young HIV infected patients which is associated with a high potential risk of suffering a PcP, especially when the strains have mutations at DHPS gene or patients suffered severe immunosuppression.
Project financed by FIS 03/1743 and FIS 04/217
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
|Back to top|