Factors associated with mortality in HIV patients with Pneumocystis jirovecii pneumonia (PCP)

Abstract

Pneumocystis jirovecii pneumonia (PCP) is a significant opportunistic infection and a major cause of mortality in HIV-infected patients. Understanding clinical characteristics that increase mortality risk is crucial for developing effective treatment strategies. This exploratory prognostic factor research employed a retrospective observational cohort design, collecting data from medical records of HIV patients diagnosed with PCP who received treatment at Pakchong Nana Hospital between 2021-2023. Sixty patients were analyzed for relationships between various characteristics and mortality using the Chi-squared test and multivariable logistic regression. Among 60 patients (mean age 34.4±12.5 years, 53.3% male), 15 patients died (25%) and 45 survived (75%). Multivariable analysis revealed characteristics significantly associated with increased mortality: not receiving antiretroviral therapy (OR 18.75, 95%CI 2.47-142.35, p=0.005), severe disease stage (OR 12.54, 95%CI 1.83-85.97, p=0.010), acute respiratory failure (OR 8.92, 95%CI 1.42-56.21, p=0.020), poor treatment compliance (OR 7.35, 95%CI 1.11-48.65, p=0.039), and ground-glass opacity on chest radiography (OR 6.28, 95%CI 1.02-38.74, p=0.048). Continuous antiretroviral therapy, prevention of respiratory failure, and promotion of treatment compliance are key factors in reducing mortality rates in this patient population. These findings provide valuable insights for improving clinical management and outcomes in HIV patients with PCP in community hospital settings.