Rituximab identified as an independent risk factor for severe PJP: A case-control study.
Adult
Aged
Aged, 80 and over
Antilymphocyte Serum
/ adverse effects
Antineoplastic Agents, Immunological
/ adverse effects
Case-Control Studies
Female
HIV Seronegativity
Hematologic Neoplasms
/ complications
Humans
Immunologic Factors
/ adverse effects
Israel
Male
Middle Aged
Multivariate Analysis
Pneumocystis carinii
Pneumonia, Pneumocystis
/ etiology
Retrospective Studies
Risk Factors
Rituximab
/ adverse effects
Steroids
/ adverse effects
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
01
2020
accepted:
28
08
2020
entrez:
11
9
2020
pubmed:
12
9
2020
medline:
3
11
2020
Statut:
epublish
Résumé
Pneumocystis jirovecii pneumonia (PJP) was reported among immunosuppressed patients with deficits in cell-mediated immunity and in patients treated with immunomodulatory drugs. The aim of this study was to identify risk-factors for PJP in noninfected HIV patients. This retrospective, test negative, case-control study was conducted in six hospitals in Israel, 2006-2016. Cases were hospitalized HIV-negative patients with pneumonia diagnosed as PJP by bronchoalveolar lavage. Controls were similar patients negative for PJP. Seventy-six cases and 159 controls were identified. Median age was 63.7 years, 65% males, 34% had hematological malignancies, 11% inflammatory diseases, 47% used steroids and 9% received antilymphocyte monoclonal antibodies. PJP was independently associated with antilymphocyte monoclonal antibodies (OR 11.47, CI 1.50-87.74), high-dose steroid treatment (OR 4.39, CI 1.52-12.63), lymphopenia (OR 8.13, CI 2.48-26.60), low albumin (OR 0.15, CI 0.40-0.54) and low BMI (OR 0.80, CI 0.68-0.93). In conclusion, rituximab, which is prescribed for a wide variety of malignant and inflammatory disorders, was found to be significant risk-factor for PJP. Increased awareness of possible PJP infection in this patient population is warranted.
Identifiants
pubmed: 32915907
doi: 10.1371/journal.pone.0239042
pii: PONE-D-20-00026
pmc: PMC7485893
doi:
Substances chimiques
Antilymphocyte Serum
0
Antineoplastic Agents, Immunological
0
Immunologic Factors
0
Steroids
0
Rituximab
4F4X42SYQ6
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0239042Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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