The effectiveness of high-dose adjunctive corticosteroid therapy in HIV-negative patients with

Background: Evidence supporting the efficacy of adjunctive corticosteroid therapy in human immunodeficiency virus (HIV)-negative patients with Methods: This retrospective cohort study included HIV-negative patients diagnosed with PJP who received adjunctive corticosteroid therapy in Zhongnan Hospital of Wuhan University from June 2018 to March 2023. Patients were categorized into high-dose group (≥1 mg/kg/day of prednisone equivalent) and low-dose group (<1 mg/kg/day). The risk was estimated by the time-dependent Cox regression analyses with inverse probability of treatment weighting (IPTW). Subgroup analysis focused on patients with respiratory failure. Results: Ultimately, 120 HIV-negative PJP patients were included (high-dose, n=72; low-dose, n=48). The overall 30- and 90-day mortality rates were 30.8% and 41.7%, respectively. No significant differences were observed in 30-day mortality (P=0.80 before analysis; P=0.62 after analysis) and 90-day mortality (P=0.86 before analysis; P=0.97 after analysis) between the two groups before and after IPTW analysis. Results in the respiratory failure subgroup were consistent with the overall findings. Conclusions: In conclusion, low-dose adjunctive corticosteroid therapy may be adequate for treating HIV-negative PJP.