自身免疫和炎症性疾病中，预防卡氏肺孢子菌肺炎不能仅仅依靠 CD4 细胞计数。
Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and inflammatory diseases.
机构信息
Department of Clinical Immunology,Saint-André Hospital, CHU de Bordeaux, France.
Department of Infectious Diseases, Saint-André Hospital, CHU de Bordeaux, France.
出版信息
Clin Exp Rheumatol. 2018 May-Jun;36(3):490-493. Epub 2018 Feb 26.
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.
目的
预防人类免疫缺陷病毒（HIV）患者肺囊虫肺炎（PCP）的指南基于 CD4 计数<200/mm³。该临界值被建议用于指导非 HIV 情况下（NHIV），特别是自身免疫和炎症性疾病（AD）的预防。我们旨在确定 CD4 是否可用于指导 AD 患者的 PCP 预防。
方法
回顾性研究了 2013 年 1 月至 2016 年 2 月期间诊断为 PCP 的患者的 CD4 和淋巴细胞计数。
结果
共纳入 129 例患者。AD 患者的中位 CD4 计数为 302/mm³，明显高于 HIV 患者（19/mm³；p<0.0001）。50%（n=10）的 AD 患者 CD4 计数大于 300/mm³。
结论
NHIV 患者，特别是 AD 患者，PCP 的预防不能仅依赖 CD4 计数。
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