Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Medical Mycology and Parasitology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
PLoS One. 2024 Mar 25;19(3):e0297619. doi: 10.1371/journal.pone.0297619. eCollection 2024.
The epidemiology of Human Immunodeficiency Virus (HIV)-associated pneumocystosis (HAP) is poorly described on a worldwide scale. We searched related databases between January 2000 and December 2022 for studies reporting HAP. Meta-analysis was performed using StatsDirect (version 2.7.9) and STATA (version 17) according to the random-effects model for DerSimonian and Laird method and metan and metaprop commands, respectively. Twenty-nine studies with 38554 HIV-positive, 79893 HIV-negative, and 4044 HAP populations were included. The pooled prevalence of HAP was 35.4% (95% CI 23.8 to 47.9). In contrast, the pooled prevalence of PCP among HIV-negative patients was 10.16% (95% CI 2 to 25.3). HIV-positive patients are almost 12 times more susceptible to PCP than the HIV-negative population (OR: 11.710; 95% CI: 5.420 to 25.297). The mortality among HAP patients was 52% higher than non-PCP patients (OR 1.522; 95% CI 0.959 to 2.416). HIV-positive men had a 7% higher chance rate for PCP than women (OR 1.073; 95% CI 0.674 to 1.706). Prophylactic (OR: 6.191; 95% CI: 0.945 to 40.545) and antiretroviral therapy (OR 3.356; 95% CI 0.785 to 14.349) were used in HAP patients six and three times more than HIV-positive PCP-negatives, respectively. The control and management strategies should revise and updated by health policy-makers on a worldwide scale. Finally, for better management and understanding of the epidemiology and characteristics of this coinfection, designing further studies is recommended.
全球范围内，人类免疫缺陷病毒（HIV）相关卡氏肺孢子菌肺炎（HAP）的流行病学情况描述不足。我们检索了 2000 年 1 月至 2022 年 12 月期间相关数据库，以获取报告 HAP 的研究。采用 StatsDirect（版本 2.7.9）和 STATA（版本 17），根据 DerSimonian 和 Laird 方法的随机效应模型和 metan 和 metaprop 命令分别进行了荟萃分析。纳入了 29 项研究，其中 HIV 阳性患者 38554 例、HIV 阴性患者 79893 例和 HAP 患者 4044 例。HAP 的总患病率为 35.4%（95%CI 23.8%至 47.9%）。相比之下，HIV 阴性患者中卡氏肺孢子菌肺炎的总患病率为 10.16%（95%CI 2%至 25.3%）。HIV 阳性患者感染卡氏肺孢子菌的风险比 HIV 阴性人群高 11.710 倍（OR：11.710；95%CI：5.420 至 25.297）。HAP 患者的死亡率比非卡氏肺孢子菌肺炎患者高 52%（OR 1.522；95%CI：0.959 至 2.416）。HIV 阳性男性患卡氏肺孢子菌肺炎的几率比女性高 7%（OR 1.073；95%CI：0.674 至 1.706）。HAP 患者预防性使用（OR：6.191；95%CI：0.945 至 40.545）和抗逆转录病毒治疗（OR 3.356；95%CI：0.785 至 14.349）的比例分别比 HIV 阳性卡氏肺孢子菌肺炎阴性患者高 6 倍和 3 倍。世界各地的卫生政策制定者应修订和更新该疾病的控制和管理策略。最后，为了更好地管理和了解这种合并感染的流行病学和特征，建议设计进一步的研究。
