PMID- 26552122
OWN - NLM
STAT- MEDLINE
DCOM- 20160104
LR  - 20190823
IS  - 0387-5911 (Print)
IS  - 0387-5911 (Linking)
VI  - 89
IP  - 2
DP  - 2015 Mar
TI  - [The Usefulness of the Scan with 67Ga-citrate to Assess the Therapeutic Effect on 
      Pneumocystis pneumonia with HIV-1 Infection].
PG  - 254-8
AB  - OBJECTIVE: Peumocystis pneumonia (PCP) is one of the common opportunistic 
      infections with severe respiratory failure, and is sometimes life-threatening in 
      patients with the acquired immunodeficiency syndrome. Although treatment for PCP 
      is established, an appropriate treatment period has not been evaluated to clarify 
      the risk factors for immune reconstitution inflammatory syndrome (IRIS) 
      associated with PCP. METHOD: We retrospectively analyzed the clinical 
      characteristics of risk factor, which are the treatment period for PCP, and 67Ga 
      scintigraphy (Ga-S) at the 21st day from the start of the treatment for PCP, with 
      21 cases of PCP and HIV infection treated during 2005-2012 at Kyushu Medical 
      Center. RESULT: The rate of residual uptake by Ga-S was assessed in 17 cases 
      (81%). Four cases were diagnosed as being PCP-IRIS, and residual uptake by Ga-S 
      was detected in all PCP-IRIS cases. The durations of the therapy were classified 
      into three groups: 21 days, 28 days, and 35 days. All PCP-IRIS cases were treated 
      in the period of 28 days. In contrast, in 11 cases that showed residual uptake by 
      Ga-S, and were treated for PCP in 35 days, PCP-IRIS did not occur. Additionally, 
      there were 4 cases in which residual uptake by Ga-S did not occur. They were 
      treated with PCP for only 21 days, but did not show PCP-IRIS. CONCLUSION: In this 
      study, we showed that Ga-S is useful to evaluate the therapeutic effect. 
      Furthermore, we found that the occurrence of PCP-IRIS could be prevented with the 
      early start of cART after 21 days treatment for PCP, when residual uptake by Ga-S 
      after the first treatment for PCP was not detected. It may also be possible to 
      start cART in the early phase after its treatment without the occurrence of 
      PCP-IRIS with the appropriate additional treatment of PCP for 14 days. These 
      guidelines for treatment of PCP in HIV-infected adults and adolescents have been 
      recommended for the duration of 21 days since 1984. We propose that for the 
      prevention of PCP-IRIS, it is nessecory to reconsider recommendation for the 
      treatment duration of 21 days, and meanwhile to evaluate the treatment effect of 
      PCP with Ga-S, because PCP resistance to sulfa drugs, namely are 
      trimethoprim-sulfamethoxazole, is beginning to appear.
FAU - Takahama, Soichiro
AU  - Takahama S
FAU - Kaku, Yu
AU  - Kaku Y
FAU - Nakashima, Eriko
AU  - Nakashima E
FAU - Minami, Rumi
AU  - Minami R
FAU - Yamamoto, Masahiro
AU  - Yamamoto M
LA  - jpn
PT  - Journal Article
PL  - Japan
TA  - Kansenshogaku Zasshi
JT  - Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious 
      Diseases
JID - 0236671
RN  - 0 (Gallium Radioisotopes)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/*complications
MH  - Adult
MH  - Female
MH  - *Gallium Radioisotopes
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pneumonia, Pneumocystis/*diagnostic imaging/etiology
MH  - Radionuclide Imaging
EDAT- 2015/11/11 06:00
MHDA- 2016/01/05 06:00
CRDT- 2015/11/11 06:00
PHST- 2015/11/11 06:00 [entrez]
PHST- 2015/11/11 06:00 [pubmed]
PHST- 2016/01/05 06:00 [medline]
AID - 10.11150/kansenshogakuzasshi.89.254 [doi]
PST - ppublish
SO  - Kansenshogaku Zasshi. 2015 Mar;89(2):254-8. doi: 
      10.11150/kansenshogakuzasshi.89.254.