Department of Family Medicine, Veterans Health Service Medical Center, Seoul 05368, Korea.
Department of Family Medicine, Graduate School of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Korean J Parasitol. 2022 Oct;60(5):327-338. doi: 10.3347/kjp.2022.60.5.327. Epub 2022 Oct 21.
This study determined the recent status and trend of Pneumocystis jirovecii pneumonia (PcP) in the non-human immunodeficiency virus (HIV) (non-HIV-PcP) and HIV (HIV-PcP) infected populations using data from the Health Insurance Review & Assessment Service (HIRA) and the Korea Disease Control and Prevention Agency (KDCA). SaTScan and Joinpoint were used for statistical analyses. Non-HIV-PcP cases showed an upward trend during the study period from 2010 to 2021, with the largest number in 2021 (551 cases). The upward trend was similar until 2020 after adjusting for the population. Seoul had the highest number of cases (1,597) in the non-HIV-PcP group, which was the same after adjusting for the population (162 cases/1,000,000). It was followed by Jeju-do (89 cases/1,000,000). The most likely cluster (MLC) for the non-HIV-PCP group was Seoul (Relative Risk (RR)=4.59, Log Likelihood Ratio (LLR)=825.531), followed by Jeju-do (RR=1.59, LLR=5.431). An upward trend was observed among the non-HIV-PcP group in the Jeju-do/Jeollanam-do/Jeollabuk-do/Gyeongsangnam-do/Busan/Daejeon/Daegu/Ulsan joint cluster (29.02%, LLR=11.638, P<0.001) located in the southern part of Korea. Both women and men in the non-HIV groups showed an overall upward trend of PcP during the study period. Men in the 60-69 age group had the highest annual percentage change (APC 41.8) during 2014-2019. In contrast, the HIV groups showed a falling trend of PcP recently. Men in the 60-69 age group had the most decrease (APC -17.6) during 2018-2021. This study provides an analytic basis for health measures and a nationwide epidemiological surveillance system for the management of PcP.
本研究利用健康保险审查与评估服务（HIRA）和韩国疾病控制与预防局（KDCA）的数据，确定了非人类免疫缺陷病毒（HIV）（非 HIV-PcP）和 HIV（HIV-PcP）感染人群中肺囊虫肺炎（PcP）的近期现状和趋势。使用 SaTScan 和 Joinpoint 进行统计分析。非 HIV-PcP 病例在 2010 年至 2021 年的研究期间呈上升趋势，2021 年病例数最多（551 例）。调整人口后，该上升趋势在 2020 年前相似。在非 HIV-PcP 组中，首尔的病例数最多（1597 例），调整人口后仍保持相同（162 例/100 万）。其次是济州道（89 例/100 万）。非 HIV-PCP 组最有可能的集群（MLC）是首尔（相对风险（RR）=4.59，对数似然比（LLR）=825.531），其次是济州道（RR=1.59，LLR=5.431）。在韩国南部的济州道/全罗南道/全罗北道/庆尚南道/釜山/大田/大邱/蔚山联合集群中，非 HIV-PcP 组呈上升趋势（29.02%，LLR=11.638，P<0.001）。在研究期间，非 HIV 组的女性和男性的 PcP 均呈总体上升趋势。2014-2019 年期间，60-69 岁年龄组男性的年百分比变化（APC 41.8）最高。相比之下，HIV 组最近 PcP 的趋势呈下降趋势。2018-2021 年期间，60-69 岁年龄组男性的下降幅度最大（APC-17.6）。本研究为卫生措施和全国性 PcP 管理的流行病学监测系统提供了分析基础。
