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

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30303 - Infectious Diseases

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2026

Kód důvěrnosti údajů

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

Název periodika

HIV Research & Clinical Practice

ISSN

2578-7489

e-ISSN

2578-7470

Svazek periodika

27

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

10

Strana od-do

-

Kód UT WoS článku

001674594800001

EID výsledku v databázi Scopus

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