Frequência de Pneumocystis jirovecii em pacientes com Sarcoma de Kaposi atendidos no Hospital Central de Maputo entre 2016 e 2019

Abstract

Pneumocystis jirovecii (P. jirovecii) is an opportunistic fungus that frequently causes pneumonia in immunosuppressed patients, especially those infected with the Human Immunodeficiency Virus (HIV) and receiving systemic corticosteroids, and may be associated with Kaposi's sarcoma (KS). In high-income countries, the incidence of P. jirovecii infection and Kaposi's sarcoma has decreased significantly due to the administration of antiretroviral therapy and prophylaxis with cotrimoxazole. In contrast, in sub-Saharan Africa, including Mozambique, the prevalence of these infections remains high, reaching a frequency of 20% in 2017. This study describes the frequency of P. jirovecii in HIV-infected KS patients treated at the Maputo Central Hospital between 2016 and 2019. The study was a cross-sectional descriptive retrospective study, which included samples of bronchoalveolar lavage (BAL) from adult patients with Kaposi's sarcoma and HIV+, stored in the biobank of the Microbiology Laboratory of the Faculty of Medicine. The molecular detection of P. jirovecii was performed using the nested polymerase chain reaction technique of the gene encoding the large subunit of mitochondrial ribosomal RNA with a molecular weight of 346 base pairs. Descriptive statistical analysis of the variables was performed using Microsoft Office Excel 2013 through the preparation of frequency tables and graphs. A total of 145 BAL samples were included in the study, of which 16 (11%) were positive for P. jirovecii. The highest frequency of colonization by P. jirovecii was observed in males 9 (56.3%), particularly in the age group of 30 to 44 years 13 (81.3%). The CD4 cell count showed that 5 (31.3%) of the patients were at low risk and 2 (12.5%) were at high risk. All patients were colonized and/or had asymptomatic infection by P. jirovecii. The study reveals cases of colonization by P. jirovecii in patients with KS and HIV infection, reinforcing the need for the diagnosis of this pulmonary mycosis to reduce its impact in the country.(TRADUÇÃO NOSSA)