A comparison of the Pnumocystis Jiroveci Pneumonia diagnosis between MSM and non-MSM male AIDS patients in Houston/Harris County, 2000-2009

Background: Pnumocystis Jiroveci Pneumonia (PJP) was the most common opportunistic infection among AIDS patients during the pre-HAART era. The advent of HAART witnessed a decrease in PJP incidence. PJP among individuals with unknown HIV infections, non-compliant patients and individuals with restricted or no access to medical care remains a public health concern. Given the preponderance of the HIV/AIDS epidemic among the “men who sex with men” risk group understanding the trends in PJP diagnoses is critical to the development of effective interventions. Methods: In this retrospective study, researchers collected information about CD4 counts and time to event comparison among the two risk groups (MSM and Non-MSM) of AIDS patients diagnosed with PJP, from 2000 to 2009 in Houston, TX. The Non-MSM group includes males who reported injection drug use, heterosexual transmission, and other/undisclosed risk. Results: PJP diagnoses has decreased overall during the 10 year period (n= 525; -0.00586, P<0.05). PJP diagnosis has also decreased significantly in the MSM group (n=251; -0.00798, P<0.05) but not in the non-MSM group (n=274; -0.00321, P=0.1308) (Cochran-Armitage test for trend). PJP diagnosis among MSM (48%) is significantly (P=0.002) lower than the non-MSM group (52%). We observed a decreasing CD4 count in the non-MSM group compared to MSM group (P<0.05). Conclusion: Our findings indicate the importance for the local Health Department to preserve the monitoring of PJP cases, especially among non-MSMs. Although detection of PJP is an important priority among all HIV patients, research efforts should be devoted to reduce PJP among non-MSM patients.