Trends in the Epidemiology and Outcomes of Pneumocystis Pneumonia among Human Immunodeficiency Virus (HIV) Hospitalizations

Int J Environ Res Public Health. 2022 Feb 27;19(5):2768. doi: 10.3390/ijerph19052768.


Introduction: Pneumocystis Pneumonia (PCP) is a common opportunistic infection among people living with the human immunodeficiency virus (HIV). This study’s objective was to assess temporal trends in PCP epidemiology among hospitalized patients with HIV/AIDS in the US and to compare data for hospitalizations with HIV with PCP to those without PCP. Methods: The national inpatient sample (NIS) data were analyzed from 2002−2014. The discharge coding identified hospitalized patients with HIV or AIDS and with or without PCP. Results: We identified 3,011,725 hospitalizations with HIV/AIDS during the study period; PCP was present in 5% of the patients with a diagnosis of HIV. The rates of PCP progressively declined from 6.7% in 2002 to 3.5 % in 2014 (p < 0.001). Overall mortality in patients with HIV was 3.3% and was significantly higher in those with PCP than without PCP (9.9% vs. 2.9%; p < 0.001). After adjusting for demographics and other comorbidities, PCP had higher odds of hospital mortality 3.082 (OR 3.082; 95% CI, 3.007 to 3.159; p < 0.001). Conclusion: From 2002 to 2014, the rate of PCP in HIV patients has decreased significantly in the United States but is associated with substantially higher mortality.

Keywords: HIV; PCP; Pneumocystis jirovecii; Pneumocystis pneumonia; antiretroviral therapy; epidemiology; human immunodeficiency virus; opportunistic infection; pneumonia.

MeSH terms

  • HIV
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Hospital Mortality
  • Hospitalization
  • Humans
  • Pneumonia, Pneumocystis* / complications
  • Pneumonia, Pneumocystis* / diagnosis
  • Pneumonia, Pneumocystis* / epidemiology
  • United States / epidemiology