ArticleInfection2026
The role of cancer and immunosuppression in pneumocystis pneumonia: a large comprehensive population-based study.
Article in Infection, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Although pneumocystis jirovecii pneumonia (PJP) in non-HIV patients is increasingly recognized, comprehensive data on immunosuppressive drivers remain limited. We conducted a population-based cohort study using a German health insurance's claims data (2015-2023). PJP, comorbidities, immunocompromising conditions and therapies were identified by means of ICD-10-GM-, ATC- and OPS-coded records. 922,200 individuals were assessed for PJP occurrence, hospitalization and 30-day all-cause mortality. An Andersen-Gill model adjusted for key covariates. We identified 171 PJP episodes, with hospitalization in 88.3% and mortality in 24.5%. Frequent immunocompromising causes were hematologic cancers (42.6%), immunosuppressants (28.7%) and steroids (28.7%). Immunosuppression rather than typical CAP risk factors strongly predicted all outcomes (HR 49.9 [31.5-78.9]). Robust associations with PJP occurred for HIV (HR 67.5 [19.4-235]), systemic steroids (> 20 mg prednisone daily equivalent (HR 26.2 [13.2-52.1])) and hematologic cancers (HR 8.5 [4.5-16.3]). Mortality was driven by hematologic cancers (HR 13.9 [4.8-40.2]) and high-dose steroids (HR 8.6 [1.6-47.1]). Malignancy-related immunosuppression and steroids critically affect PJP risk and prognosis.
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