Risk of Pneumocystis jirovecii Pneumonia in Patients With HIV in Taiwan: Evidence from a Cross-sectional Study.

Background/aim: Studies have demonstrated that patients with HIV are at a higher risk of Pneumocystis jirovecii pneumonia (PJP). Epidemiological knowledge of the risk of PJP among patients with HIV infection is lacking. This study aimed to assess the risk of PJP among patients with HIV.

Patients and methods: This cross-sectional study was conducted using the National Health Insurance Research Database of Taiwan. The participants were 18,929 patients with new-onset HIV infection from 2002 to 2015. Each patient was matched with four HIV-negative patients for age, sex, insured salary, urbanization status, Charlson Comorbidity Index score, and year of enrollment. The logistic regression with adjustment for relevant variables was performed to analyze the risk of PJP among patients with HIV at the 3-year follow-up. Sensitivity analysis was performed to compare the risk of PJP among different cohorts (patients with chronic kidney disease) and at different follow-up periods (6-month, 1-year, and 2-year follow-up).

Results: Patients with HIV had a higher risk of PJP [adjusted odds ratio (aOR)=199.36; 95% confidence interval (CI)=119.47-332.66] than HIV-negative individuals at the 3-year follow-up. Male patients had a higher risk of PJP (aOR=1.62; 95%CI=1.18-2.24) than female patients. Patients with chronic obstructive pulmonary disease (COPD) had a higher risk of PJP (aOR=1.74; 95%CI=1.27-2.39) at the 3-year follow-up.

Conclusion: Patients with HIV had a higher risk of PJP. Male patients had a higher risk of PJP than female patients. The risk of PJP was higher among patients with COPD.