PNEUMOCYSTIS IN PATIENTS LIVING WITH HIV: EXPERIENCE OF THE INFECTIOUS DISEASES DEPARTMENT OF CHU MOHAMED VI-MARRAKECH

Pneumocystis is the most serious and common respiratory opportunistic infection after tuberculosis during HIV infection. To describe the epidemiological, clinical, therapeutic and evolutionary aspects of HIV-infected patients who presented with pneumocystis. Retrospective study of the records of 45 HIV-infected patients followed at the Department of Infectious Diseases of the CHU Mohamed VI and hospitalized for Pneumocystis jirovecii infection between January 2007 and March 2021. Out of 1286 HIV-infected patients followed at the department during the study period, 45 patients (3.5%) had pneumocystis. Pneumocystis was inaugural to HIV infection in 36 cases (80%). The predominance was male in 63% of cases (28 males to 17 females), with an average age of 35.5 years [16-64 years]. The mean TCD4 cell count was 74 cells/mm3 [0- 656 cells/mm3]. The mean LDH level was 874.89 IU/L. The clinical picture was marked by cough in 84% of cases and dyspnea in 64% of cases. The most frequent radiological signs were a diffuse interstitial syndrome in 84.4% of cases on chest X-ray and ground glass appearance in 63% of cases on chest CT. The diagnosis of pneumocystis was confirmed in 16 patients by the detection of Pneumocystis jIrovecii in sputum and BAL. All our patients were treated with Trimethoprim-Sulfamethoxazole combination. Antiretroviral treatment was started in 32 patients, i.e. 71% of the patients, with a favorable evolution in 24 patients, i.e. 53%. Pneumocystis is a serious infection in immunocompromised patients especially PLHIV. In Morocco, it is still frequent during HIV infection and is one of the main causes of death.