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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24178

Title: The role of CD4 cell count as discriminatory measure to guide chemoprophylaxis against Pneumocystis jirovecii pneumonia in human immunodeficiency virus-negative immunocompromised patients: A systematic review
Authors: Messiaen, Peter E.
Cuyx, Senne
Dejagere, Tom
van der Hilst, Jeroen C.
Issue Date: 2017
Publisher: WILEY
Citation: TRANSPLANT INFECTIOUS DISEASE, 19(2), p. 1-6 (Art N° e12651)
Abstract: Background: In recent years, the incidence of Pneumocystis jirovecii pneumonia (PJP) has increased in immunocompromised patients without human immunodeficiency virus (HIV) infection. Chemoprophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX) is highly effective in preventing PJP in both HIV-positive and -seronegative patients. In HIV-positive patients, the risk of PJP is strongly correlated with decreased CD4 cell count. The role of CD4 cell count in the pathogenesis of PJP in non-HIV immunocompromised patients is less well studied. For most immunosuppressive conditions, no clear guidelines indicate whether to start TMP-SMX. Method: We conducted a systematic literature review with the aim to provide a comprehensive overview on the role of CD4 cell counts in managing the risk of PJP in HIV-seronegative patients. Results: Of the 63 individual studies retrieved, 14 studies report on CD4 cell counts in a variety of immunosuppressive conditions. CD4 cell count were < 200/mu L in 73.1% of the patients. Conclusion: CD4 cell count < 200/mu L is a sensitive biomarker to identify non-HIV immunocompromised patients who are at risk for PJP. Measuring CD4 cell counts could help clinicians identify patients who may benefit from TMP-SMX prophylaxis.
Notes: [Messiaen, Peter E.; Cuyx, Senne; van der Hilst, Jeroen C.] Jessa Hosp, Dept Infect Dis & Immun, Hasselt, Belgium. [Messiaen, Peter E.; van der Hilst, Jeroen C.] Hasselt Univ, Biomed Res Inst BIOMED, Hasselt, Belgium. [Dejagere, Tom] Jessa Hosp, Dept Nephrol, Hasselt, Belgium.
URI: http://hdl.handle.net/1942/24178
DOI: 10.1111/tid.12651
ISI #: 000398574400001
ISSN: 1398-2273
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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