How prevalent is Pneumocystis jiroveci pneumonia (PJP)?

Updated: Apr 24, 2019
  • Author: Shelley A Gilroy, MD, FACP, FIDSA; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Answer

Before the widespread use of prophylaxis for P jiroveci pneumonia (PJP), the frequency of Pneumocystis infection in lung transplant patients alone was as high as 88%. Now, with the routine use of prophylaxis, PJP is very rare in solid-organ transplant patients and has significantly decreased in patients infected with HIV.

Prior to the widespread use of highly active antiretroviral therapy (HAART), PJP occurred in 70%-80% of patients with HIV infection. The frequency of PJP is decreasing with the use of PJP prophylaxis and HAART. PJP is still the most common opportunistic infection in patients with HIV infection. Patients with HIV infection are more prone to PJP recurrence than patients not infected with HIV.

In developing regions of the world, the prevalence of PJP was once thought to be much lower, [18] but studies have shown that the lower reported incidence is likely a failure to accurately diagnose PJP. An accurate diagnosis requires access to modern medical care, which is not available worldwide.

Currently, the frequency of documented Pneumocystis infection is increasing in Africa, with Pneumocystis organisms found in up to 80% of infants with pneumonia who have HIV infection. In sub-Saharan Africa, tuberculosis is a common co-infection in persons with PJP. [19]


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