Early Symptoms Of AIDS Pneumocystis jiroveci pneumonia

AIDS: Opportunistic Infections

Pneumocystis jiroveci pneumonia

Pneumocystis jiroveci pneumonia (formerly called Pneumocystis carinii or PCP) is the most common opportunistic infection among HIV patients. Before antiretroviral therapy and preventative treatment was available, about 70-80% of people with HIV developed PCP. However, this number has been declining significantly over the years.

Originally, researchers thought a one-cell organism called Pneumocystis carinii caused the infection. However, recent research suggests that a fungus called Pneumocystis jiroveci is the cause. The condition is still commonly referred to as
Pneumocystis carinii pneumonia (PCP).

According to the U.S. Centers for Disease Control and Prevention (CDC), PCP is classified as an AIDS-defining illness. This means that when HIV-infected patients develop PCP, their condition has progressed to AIDS. Individuals with a CD4 cell
(helper T-cells that help fight against disease and infection) count lower than 200 cells per microliter of blood have the greatest risk of developing PCP. In addition, people who have CD4 cell counts lower than 300 who have already had another
opportunistic infection have an increased risk of developing PCP.

This infection almost always affects the lungs causing a type of pneumonia. The first signs of PCP are difficulty breathing, fever, and a dry cough. Other common symptoms include chest discomfort, weight loss, chills, tachypnea (rapid breathing), tachycardia (fast heart rate), mild crackles (bubbling or rattling sounds that occur when air moves through fluid-filled airways), cyanosis (bluish discoloration of the skin), nasal flaring, and intercostal retractions (visible use of muscles between the ribs, which indicates labored breathing). The patient may also cough up blood, although this is considered a rare symptom.

Historically, mortality ranged from 20-40%, depending on the severity of the disease when it was diagnosed. Today, however, mortality rates range between 10-20%.

Today, PCP is almost entirely preventable, and it can be treated effectively with medications. Unfortunately, PCP is still common in patients who are infected with HIV for a long time before they begin antiretroviral therapy (ART). In fact, 30-40%
of HIV patients develop PCP if they begin treatment when their CD4 cell counts are very low (around 50 cells per microliter of blood).