Gildas Baulier1, Nahema Issa2, Frederic Gabriel3, Isabelle Accoceberry3, Fabrice Camou4, Pierre Duffau5. 1. Department of Clinical Immunology,Saint-André Hospital, CHU de Bordeaux, France. gildas.baulier@chu-bordeaux.fr. 2. Department of Infectious Diseases, Saint-André Hospital, CHU de Bordeaux, France. 3. Department of Mycology and Parasitology, Pellegrin Hospital, CHU de Bordeaux, France. 4. Intensive Care Unit, Saint-André Hospital, CHU de Bordeaux, France. 5. Department of Clinical Immunology,Saint-André Hospital, CHU de Bordeaux, France.
Abstract
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.
OBJECTIVES: Guidelines for preventing Pneumocystis pneumonia (PCP) in HIVpatients 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 HIVpatients (19/mm3; p<0.0001). Fifty percent (n=10) of ADpatients had CD4 counts greater than 300/mm3. CONCLUSIONS: Prophylaxis for PCP cannot rely solely on CD4-count in NHIV patients especially in AD.
Authors: C A Pereda; M B Nishishinya-Aquino; N Brito-García; P Díaz Del Campo Fontecha; I Rua-Figueroa Journal: Rheumatol Int Date: 2021-03-03 Impact factor: 2.631
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