A rare case of an HIV-seronegative AIDS patient with Pneumocystis jirovecii pneumonia

Autor: Qiaofei Zheng, Youzu Xu, Jiaxi Feng, Shuangquan Yan, Zhuolin Gao, Jing Huang, Hongguo Zhu
Rok vydání: 2019
Předmět:
Male
0301 basic medicine
medicine.medical_specialty
030106 microbiology
Case Report
Disease
Window period
Pneumocystis carinii
lcsh:Infectious and parasitic diseases
Young Adult
03 medical and health sciences
0302 clinical medicine
Medical microbiology
Acquired immunodeficiency syndrome (AIDS)
Antiretroviral Therapy
Highly Active
medicine
Humans
Pneumocystis jirovecii
lcsh:RC109-216
030212 general & internal medicine
AIDS patients
Acquired Immunodeficiency Syndrome
HIV-seronegative
AIDS-Related Opportunistic Infections
biology
business.industry
Pneumonia
Pneumocystis
virus diseases
medicine.disease
biology.organism_classification
Pneumocystis jirovecii pneumonia
Anti-Bacterial Agents
CD4 Lymphocyte Count
Treatment Outcome
Infectious Diseases
Immunology
Etiology
biology.protein
RNA
Viral
Antibody
business
Viral load
Zdroj: BMC Infectious Diseases
BMC Infectious Diseases, Vol 19, Iss 1, Pp 1-7 (2019)
ISSN: 1471-2334
DOI: 10.1186/s12879-019-4143-8
Popis: Background As technology progresses, several highly sensitive human immunodeficiency virus (HIV) screening kits are being researched and developed to quickly and efficiently identify serum HIV antibodies within the non-window period. In individuals who are HIV-seronegative, HIV infections that are not within a window period are rare. In such cases, all antibody detection methods will fail, and misdiagnosing these patients will have catastrophic consequences. Case presentation A 22-year-old male Chinese patient with diffuse exudative lesions in both lungs and initial symptoms of cough and dyspnoea was diagnosed with Pneumocystis jirovecii pneumonia (PJP) by aetiological examination, and the patient’s plasma CD4+ T-cell count was extremely low. In China, PJP is prevalent in HIV-infected individuals. Pneumocystis jirovecii (P. jirovecii) has a high colonisation rate in patients with HIV infections. This patient was naturally suspected of being an HIV patient; however, serum HIV antibody tests were negative using both an enzyme-linked immunosorbent assay (ELISA) and a latex agglutination assay, and HIV was not detected by western blotting. Subsequently, the plasma HIV viral load was found to be extremely high on two repeated plasma HIV RNA tests, thus confirming HIV-seronegative acquired immunodeficiency syndrome (AIDS) in this patient. With administration of effective anti-P. jirovecii treatment and highly active antiretroviral therapy (HAART) after diagnosis, the patient’s disease condition was rapidly controlled. Conclusion This is the second reported case in China of an HIV-seronegative AIDS patient. Such cases are also rare worldwide. Although HIV-seronegative HIV infections are rare, AIDS should be considered in immunodeficient patients with opportunistic infections, even if the test results are HIV-seronegative. Plasma HIV RNA testing is important for such patients. Electronic supplementary material The online version of this article (10.1186/s12879-019-4143-8) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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