Table 2 Summary of literature reported cases of HIV-positive patients with IRD to PCP after HAART
Case [Ref.] Sex/Age | CD4 (/μL) & HIVRNA (log10 copies/ml) before HAART | Therapy of PJP & HAART regimen | Day of HAART after initiation of PCP treatment | Symptoms & signs during IRD | Day of IRD after initiation of HAART | Day of steroid withdrawal before the onset of IRD | CD4 (/μL) & HIVRNA (log10 copies/ml) during IRD | Therapy of IRD & clinical outcome |
|---|---|---|---|---|---|---|---|---|
1 [28] M/37 | 7 & 5.1 | Cotrimoxazole & MP; zidovudine, lamivudine, & indinavir | 16 days | High fever, acute respiratory failure; CXR: patchy alveolar opacities in both upper lobes | 7 days | 7 days | 38 & UD | Restart cotri-moxazole & stop HAART; survived |
2 [28] M/47 | 28 & 5.0 | Cotrimoxazole & MP, then aerosolized pentamidine; viramune, stavudine, & didanosine | 1 day | High fever, acute respiratory failure requiring intubation; CXR: diffuse alveolar opacities | 17 days | 2 days | 40 & 4.5 | Restart MP & stop HAART; survived |
3 [28] F/50 | 230 & 5.8 | Cotrimoxazole & MP; zidovudine, lamivudine, & indinavir | 16 days | High fever, acute respiratory failure; CXR: patchy alveolar opacities in both upper lobes | 7 days | 7 days | 564 & 3.1 | Start Atovaquone, aerosolized pentamidine, & steroid; survived |
4–6 [29] NM | 26 & 5.5 (median) | Cotrimoxazole & high dose steroid; NM | 15 – 18 days (range) | Swinging fever, acute respiratory failure, & radiological deterioration | 5 days (median); 3–17 days (range) | NM | 62 & 2.87 (median) | Re-introducing high dose steroids & alternative PJP therapy; all three patients survived |
7 [30] M/38 | 4 & 5.5 | Atovaquone; didanosine, efavirenz, nelfinavir, & stavudine | 35 days | Fever, cough, dyspnoea, & night sweats; CXR: bilateral mid & lower zone airspace shadow | 14 days | NA | 125 & 3.6 | Intravenous pentamidine & hydrocortisone; survived |
8 [30] NM | 70 & NM | Cotrimoxazole; zidovudine | Â | Â | Â | Â | 182 & NM | Cotrimoxazole; survived |
9 [30] NM | 10 & NM | Cotrimoxazole; zidovudine | 21 days (median) 17–24 days (range) | Fever, dyspnoea, with or without cough | 15 days (median) 5–30 days (range) | NM | 30 & NM | Supportive therapy |
10 [30] NM | 216 & NM | Cotrimoxazole & steroid; zidovudine | Â | Â | Â | Â | 340 & NM | Cotrimoxazole & steroid |
11 [30] NM | 290 & NM | Cotrimoxazole; zidovudine, & didanosine | Â | Â | Â | Â | 430 & NM | Cotrimoxazole |
12 [30] NM | 60 & NM | Cotrimoxazole; zidovudine | Â | Â | Â | Â | 130 & NM | Supportive therapy |
13 [31] M/34 | 46 & > 5.9 | Cotrimoxazole; zidovudine, lamivudine, lopinavir-ritonavir | 18 days | Recurrent fever, chest discomfort, cough, & dyspneoa; CXR showed diffuse bilateral reticulonodular infiltrates | 14 days | NA | 435 & 4.5 | Cotrimoxazole (pro-phylactic dose) & keeping HAART; survived |