ReviewHIV medicine2025
Pneumocystis jirovecii pneumonia-Immune reconstitution inflammatory syndrome: A review of published cases.
Review in HIV medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Pneumonia caused by co-infection with Mycobacterium tuberculosis and Pneumocystis jirovecii leading to acute respiratory distress syndrome in an HIV-negative immunocompromised patient: a case report and literature review.BMC infectious diseases · 2026Review
- Unilateral Pneumocystis-associated immune reconstitution inflammatory syndrome: A case illustrated.IDCases · 2026Article
- Neuroinflammation in fungal infections: from pathogen recognition to pathological manifestations.Disease models & mechanisms · 2025Review
- Individualized Trimethoprim-Sulfamethoxazole Dosing in Non-HIV Patients with Pneumocystis Pneumonia: A Narrative Review of Current Evidence.Journal of personalized medicine · 2025Review
- Pneumocystis jirovecii pneumonia-Immune reconstitution inflammatory syndrome: A review of published cases.HIV medicine · 2025Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmune reconstitution inflammatory syndrome (IRIS) can occur in patients with HIV after commencing antiretroviral therapy. Tuberculosis-IRIS is the most common, and Pneumocystis jirovecii pneumonia (PJP)-IRIS accounts for only 2.7%-4% of IRIS cases. The prognosis and management of IRIS is well studied in other opportunistic infections but is ill defined for PJP-IRIS, and no guidelines exist. We reviewed the literature to consolidate the available data for PJP-IRIS to formulate recommendations for the diagnosis and management of this condition.
methodsWe performed a literature review of cases of PJP-IRIS and included cases in Australia that had not been previously published. We searched the Web of Science, MEDLINE, Embase, SCOPUS databases and grey literature sources for studies reporting cases of PJP-IRIS between January 1981 and August 2024. We provide a synthesis of published cases evaluating pathogenesis, mortality, and therapeutic options.
resultsIn total, 51 patients were identified from 25 data sources. Two mortalities were described. We found that 22% of PJP-IRIS cases required support in the intensive care unit. Antimicrobial treatment for PJP was given in 32 cases, and trimethoprim-sulfamethoxazole was the most prescribed. Extending the duration of PJP therapy beyond the usual 21 days did not appear to affect outcomes. Corticosteroids were given in 26 (52%) cases, not given in 12 cases (20%), and use was not stated in 13 cases (26%). The type and dose of steroid used varied and was described in 15 cases. DISCUSSION: Mortality in PJP-IRIS appears lower than in IRIS secondary to other opportunistic infections. Prompt treatment with corticosteroids at a dose proportionate to disease severity is recommended. Extending antimicrobials for PJP beyond 21 days does not appear to offer clinical benefit in patients with PJP-IRIS. With the rise of immunotherapy, new treatments could be on the horizon for PJP-IRIS.
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