Limited Asymptomatic Carriage of Pneumocystis jiroveci in Human Immunodeficiency Virus–Infected Patients

• Published in: The Journal of infectious diseases Vol. 187; no. 6; pp. 901 - 908
• Main Authors: Wakefield, Ann E, Lindley, Austin R, Ambrose, Helen E, Denis, Cecile-Marie, Miller, Robert F
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.03.2003; University of Chicago Press; Oxford University Press
• Subjects: AIDS; AIDS-Related Opportunistic Infections - complications; Ascomycota - genetics; Ascomycota - isolation & purification; Biological and medical sciences; Bronchoalveolar Lavage Fluid - microbiology; Carrier State - microbiology; Cytomegalovirus; DNA; DNA, Fungal - analysis; DNA, Fungal - genetics; Genetic loci; Genotype; Genotypes; HIV Infections - complications; HIV-1; HIV/AIDS; Human viral diseases; Humans; Infections; Infectious diseases; Lung Diseases, Fungal - complications; Lung Diseases, Fungal - diagnosis; Medical sciences; Pneumocystis; Pneumocystis carinii; Pneumocystis pneumonia; Polymerase chain reaction; Polymorphism, Genetic; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Fungi; Infection; Human; Immunopathology; Viral disease; AIDS; Asymptomatic; Pneumocystis; Fungi Imperfecti; Immune deficiency; Colonization; Thallophyta
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/368165

Forty-seven bronchoalveolar lavage fluid samples from 16 human immunodeficiency virus (HIV)–infected patients were used to test the latency model of Pneumocystis infection in the human host. Identification of DNA sequence polymorphisms at 4 independent loci were used to genotype Pneumocystis jiroveci from the 35 samples that contained detectable P. jiroveci DNA. Eighteen of those 35 samples came from patients who did not have Pneumocystis pneumonia (PCP) and had confirmed alternative diagnoses. Seven patients had asymptomatic carriage of P. jiroveci over periods of ⩽9.5 months after an episode of PCP, and in all 7 cases, a change in genotype from that in the original episode of PCP was observed. The absence of P. jiroveci DNA in one-fourth of the 47 samples and the observed changes in genotype during asymptomatic carriage do not support the latency model of infection. Asymptomatic carriage in HIV-infected patients may play a role in transmission of P. jiroveci and may even supply a reservoir for future infections