Background Pneumocystis carinii pneumonia (PJP) infection often affects immunocompromised patients may cause severe morbidity and mortality. PJP may be preventable by prophylactic antibiotics in high risk patients. However, the epidemiology and risk factors for PJP in patients with systemic lupus erythematosus (SLE) are not full studied.
Objectives This nationwide population-based study aimed to evaluate the risk of PJP in patients with systemic lupus erythematosus in Taiwan.
Methods We identified 23,378 SLE patients from the National Health Insurance research database between 1997 and 2012 and compared the incidence rate (IR) of PJP infection with that of 93,512 age- and gender-matched non-SLE cohort. A Cox multivariable proportional hazards model was applied to evaluate the risk of PJP infection in the SLE cohort. Risk factors of PJP infection were also analyzed.
Results The SLE cohort had a significantly higher IR of PJP infection (SLE IR=2.49, control IR=0.10, incidence rate ratio = 26.06, p<0.001). Male (Hazard ratio [HR] = 2.05, p=0.039), end stage renal disease (HR=1.88, p=0.035), use of mycofenolate mofetil (HR=5.11, p<0.001), intravenous steroid pulse therapy (HR=96.23, p<0.001).
Conclusions Higher risk of PJP infection was observed in SLE patients. Risk factors for PJP infection include male, end stage renal disease, use of mycofenolate mofetil, intravenous steroid pulse therapy and an oral daily steroid dose over 7.5mg.
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Disclosure of Interest None declared