I am a registered nurse with 20 years’ experience working with patients who have human immunodeficiency virus (HIV/AIDS). Pneumocystis carinii pneumonia is a fungal infection found in individuals suffering from an immunocompromised state due to HIV/AIDS. Despite the advances in antiretroviral therapy, this disease continues to cause deaths in patients with HIV/AIDS with a lowered CD4 counts due to non-adherence to the antiretroviral treatment (Barry & Johnson, 2001). I chose this article to research the reasons for the increased disease burden from pneumocystis carinii pneumonia, apart from medication non-adherence and psychosocial and socioeconomic issues.
First, the deaths from pneumocystis pneumonia are due to the latent organisms’ activation in the lungs. The immunocompromisation of the body due to HIV/AIDS reduces its ability to remove the latent microorganisms, resulting in their reactivation to cause severe diseases (Barry & Johnson, 2001). Second, the pneumocystis carinii pneumonia infection is transmissible to other personnel with impaired immunity. Hence, care practitioners should isolate patients suffering from this disease from other immunocompromised patients during the early stages of treatment.
Another factor attributable to the deaths from pneumocystis carinii pneumonia is gene mutations against co-trimoxazole treatment. According to Barry & Johnson (2001), researchers have detected gene variation in the dihydropteroate synthase enzyme hindering efficacy with co-trimoxazole. The spread of the new resistant strains further complicates the treatment of this fungal infection. Moreover, the poor prognosis from pneumocystis carinii patients undergoing treatment using mechanical ventilation is evident. A 100 percent mortality rate was observed in individuals with a CD4 count less than 10cells/ml compared to 25 percent death rates in those with a CD4 count greater than 100cells/ml (Barry & Johnson, 2001). However, prophylaxis with co-trimoxazole, dapsone, and inhaled pentamidine in patients with CD4 counts less than 200cells/ml is beneficial in reducing the mortality rates of pneumocystis carinii pneumonia. Therefore, healthcare personnel should encourage adherence to antiretroviral therapy in immunocompromised patients to raise their CD4 counts. Medical practitioners should follow infection prevention protocols, including isolation and hygiene, to reduce the spread of infection to susceptible population.
Barry, S. M., & Johnson, M. A. (2001). Pneumocystis carinii pneumonia: A review of current issues in diagnosis and management. HIV Medicine, 2(2), 123–132. doi: 10.1046/j.1468-1293.2001.00062.x