Udwadia Z F, Doshi Amita V, Bhaduri Anita S
Department of Chest Medicine, PD Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai 400016.
J Assoc Physicians India. 2005 May;53:437-40.
Pneumocystis carinii pneumonia (PCP) is believed to be rare in the developing world and no large prospective Indian series have been reported to date. The present study was conducted to study the clinical profile and outcome of PCP in patients with HIV infection.
All HIV positive patients with PCP admitted over 4 years (2000-2003) to a tertiary referral centre in Mumbai were prospectively studied.
There were 38 patients with proven PCP from 300 HIV admissions. The patients with PCP were predominantly male (M: F = 5.4:1), with a mean age of 40.1 years. The median CD4 count of the PCP group was 96 cells/microL. Bronchoscopy was needed to make a definitive diagnosis in 17 of the 38 patients. PCP co-existed with tuberculosis in 4 of the 38 patients. The mortality of the group was high at 15.8% with all patients needing ventilatory support dying.
PCP is not an uncommon infection in Indians with advanced HIV. Lack of recognition has probably been responsible for the absence of any large series from this country. In our series of hospitalised HIV positive patients, PCP was the second commonest pulmonary disease after tuberculosis accounting for 32% of pulmonary admissions and 13 % of all HIV positive admissions.
卡氏肺孢子虫肺炎（PCP）在发展中国家被认为较为罕见，且迄今为止尚无来自印度的大型前瞻性系列报道。本研究旨在探讨HIV感染患者中PCP的临床特征及转归。
对2000年至2003年4年间入住孟买一家三级转诊中心的所有确诊为PCP的HIV阳性患者进行前瞻性研究。
在300例HIV住院患者中，有38例确诊为PCP。PCP患者以男性为主（男：女 = 5.4：1），平均年龄为40.1岁。PCP组的CD4细胞计数中位数为96个/微升。38例患者中有17例需要通过支气管镜检查来明确诊断。38例患者中有4例PCP与结核病并存。该组死亡率较高，为15.8%，所有需要通气支持的患者均死亡。
PCP在晚期HIV感染的印度患者中并非罕见感染。缺乏认识可能是该国尚无大型系列报道的原因。在我们的住院HIV阳性患者系列中，PCP是继结核病之后第二常见的肺部疾病，占肺部住院患者的32%，占所有HIV阳性住院患者的13%。
