Unmasking the impact of cytomegalovirus reactivation in people with advanced HIV disease with Pneumocystis Jirovecii pneumonia: does antiviral therapy change outcomes?

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064211%3A_____%2F26%3AW0000006" target="_blank" >RIV/00064211:_____/26:W0000006 - isvavai.cz</a>

Result on the web

<a href="https://oadoi.org/10.1080/25787489.2026.2621466" target="_blank" >https://oadoi.org/10.1080/25787489.2026.2621466</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1080/25787489.2026.2621466" target="_blank" >10.1080/25787489.2026.2621466</a>

Result language

angličtina

Original language name

Unmasking the impact of cytomegalovirus reactivation in people with advanced HIV disease with Pneumocystis Jirovecii pneumonia: does antiviral therapy change outcomes?

Original language description

BackgroundPneumocystis jirovecii pneumonia (PJP) remains a leading opportunistic infection in people with HIV and severe immunodeficiency. While PJP treatment has been well studied, the clinical significance of cytomegalovirus (CMV) DNA detection during PJP and the role of specific anti-CMV therapy remain uncertain.ObjectivesTo examine associations between CMV DNA detection, anti-CMV therapy, and clinical outcomes in people with HIV hospitalized with PJP.MethodsThis retrospective cohort study examined people with HIV hospitalized with PJP between 2008 and 2022 at University Hospital Bulovka. A customized severity index was developed for this cohort. In-hospital mortality, one-year survival, and disease severity were assessed, focusing on CMV DNA detection and its treatment. Data were analyzed using Firth penalized logistic regression to identify associations with clinical outcomes, and ordinal logistic regression to assess predictors of severity scores in this observational cohort.ResultsOne hundred and one patients were included. In unadjusted analyses, CMV DNA detection was associated with higher odds of both in-hospital and one-year mortality, and anti-CMV therapy was associated with increased in-hospital mortality. In multivariable analyses, CMV DNA detection was not independently associated with in-hospital or one-year mortality, although point estimates consistently suggested higher odds of death. Receipt of anti-CMV therapy was not independently associated with mortality after adjustment. The severity index was independently associated with both in-hospital and one-year mortality. CMV DNA detection and anti-CMV therapy were independently associated with greater disease severity in ordinal regression analyses. Anti-CMV therapy was more frequently administered to patients with more severe disease and was also associated with in-hospital mortality.ConclusionsCMV DNA detection in people with HIV hospitalized with PJP was associated with worse outcomes. Anti-CMV therapy was more often used in severe cases and showed an association with in-hospital mortality in unadjusted analyses. The observational design precludes determination of causality.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30303 - Infectious Diseases

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2026

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

HIV Research & Clinical Practice

ISSN

2578-7489

e-ISSN

2578-7470

Volume of the periodical

27

Issue of the periodical within the volume

1

Country of publishing house

GB - UNITED KINGDOM

Number of pages

10

Pages from-to

-

UT code for WoS article

001674594800001

EID of the result in the Scopus database

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