Volume 10, Number 10—October 2004
Perspective
Dihydropteroate Synthase Gene Mutations in Pneumocystis and Sulfa Resistance
Table 2
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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