Brief Papers
Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and inflammatory diseases
G. Baulier1, N. Issa2, F. Gabriel3, I. Accoceberry4, F. Camou5, P. Duffau6
- Department of Clinical Immunology,Saint-André Hospital, CHU de Bordeaux, France. gildas.baulier@chu-bordeaux.fr
- Department of Infectious Diseases, Saint-André Hospital, CHU de Bordeaux, France.
- Department of Mycology and Parasitology, Pellegrin Hospital, CHU de Bordeaux, France.
- Department of Mycology and Parasitology, Pellegrin Hospital, CHU de Bordeaux, France.
- Intensive Care Unit, Saint-André Hospital, CHU de Bordeaux, France.
- Department of Clinical Immunology,Saint-André Hospital, CHU de Bordeaux, France.
CER10722
2018 Vol.36, N°3
PI 0490, PF 0493
Brief Papers
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PMID: 29533748 [PubMed]
Received: 29/07/2017
Accepted : 04/12/2017
In Press: 26/02/2018
Published: 17/05/2018
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.
