Volume 10, Number 10—October 2004
Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance
|Author (y) (ref)||PCP cases, no.||Location (time period), country||Prophylaxisb definition (source of information)||DHPS mutations among persons using prophylaxis N (%)||DHPS mutations among persons not using prophylaxis N (%)||p value|
|Kazanjian (1998) (19)||27 (20 HIV-infected)||Ann Arbor, MI (1991–1997), USA||5/7 (71)c||2/20 (10)c||0.0032|
|Indianapolis, IN (1976–1997), USA||At least 1 out of 4 months preceding PCP (chart)||5/7 (71)d||2/13 (15)d||0.022|
|Helweg-Larsen (1999) (20)||152||Copenhagen (1989–1999), Denmark||Exposuree (chart)||18/29 (62)||13/123 (11)||< 0.0001|
|Prophylaxisf (chart)||5/7 (71)g||15/125 (12)||0.01|
|Ma (1999) (21)||37 (26 HIV-infected)||Bethesda, MD (1985–1998), USA||Any (chart)||11/14 (79)||2/18 (11)||< 0.001|
|Kazanjian (2000) (22)||97||Denver, CO, Indianapolis, IN, Boston, MA, Detroit, MI (1991–1997), USA||At least 1 out of 4 months preceding PCP (chart)||28/37 (76)||14/60 (23)||< 0.001|
|Huang (2000) (23)||111||Atlanta, GA, Seattle, WA, San Francisco, CA (1996–1999), USA||Ever (interview), Any in the 3 months preceding PCP (chart and interview)||57/71 (80)||19/40 (48)||< 0.001|
|Visconti (2001) (24)||20||Rome (1992–1997), Italy||(Chart)||4/5 (80)||4/15 (27)||0.031|
|Ma (2002) (25)||107||Milan (1994–2001), Italy||Any in the 6 months preceding PCP (chart)||6/31 (19)||3/76 (4)||0.017|
|Costa (2003) (29)||89 (83 HIV-infected)||Lisbon (1994–2001), Portugal||Prophylaxish Exposurei||6/17 (35)||18/72 (25)||0.39|
|Nahimana (2003) (30)||158 (120 HIV-infected)||Lyon (1993–1996), France||Prophylaxisj||16/20 (80)||41/138 (30)||< 0.001|
aPCP, Pneumocystis pneumonia; dihydropteroate synthase (DPHS); TMP-SMX, trimethoprim-sulfamethoxazole.
bProphylaxis refers to persons using TMP-SMX or dapsone who met the specific criteria described.
cThe seven specimens with DHPS gene mutations were from 1995 to 1997.
dAnalysis restricted to 20 HIV-infected persons.
eExposure, continuous use for at least 1 week at any time after the diagnosis of HIV infection.
fProphylaxis at least 8 weeks preceding PCP.
gAnalysis restricted to patients receiving TMP-SMX or dapsone prophylaxis versus no prophylaxis.
hProphylaxis, adherence to the same regimen for a minimum of 2 months preceding PCP.
iExposure, use for at least 1 week in the 6 months preceding PCP.
jProphylaxis 3 months preceding PCP. Includes patients who received pyrimethamine/sulfadoxine for PCP prophylaxis.
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