C55-31 Pneumocystosis Challenge in People Living With HIV Admitted to the ICU at the National Institute of Respiratory Diseases in Mexico

Abstract Introduction Pneumocystis jirovecii pneumonia remains a leading cause of admission to intensive care units and mortality among people living with HIV. Despite its high prevalence and impact on patient mortality, it continues to be an entity that requires ongoing research and characterization. Identifying factors associated with increased mortality is useful for updating physicians' knowledge and enabling early intervention, thus improving diagnostic and therapeutic outcomes. Methods A retrospective cohort study was conducted, including 54 people living with HIV (PLHIV) with a confirmed diagnosis of Pneumocystis jirovecii pneumonia (PCP) admitted to the ICU at the National Institute of Respiratory Diseases in Mexico City between 2022 and 2024. Demographic, clinical, and laboratory characteristics were considered, as well as survival analysis. Results Fifty-four cases were included, all of whom required invasive mechanical ventilation. A statistically significant association was found between lower educational level and mortality (p = 0.014). Associated coinfections included tuberculosis, histoplasmosis, and CMV. Severe immunosuppression was noted, with a median CD4 count of 19 cells/µL (IQR 11-52) and a high viral load, median 303,406 copies/mL (IQR 34,696-999,104 cells/µL). Mortality was reported at 40.07%, and lower survival was associated with positive CMV serology (p = 0.019) and disseminated tuberculosis (p = 0.021). Conclusion People living with HIV (PLHIV) and people with HIV/AIDS (PWA) had severe immunosuppression, high viral load, and opportunistic infections within the context of socioeconomic vulnerability. Mortality remains high (40.7%), with decreased survival associated with CMV and tuberculosis. Despite the knowledge and treatment of both pneumocystosis and HIV, it remains vital to conduct adequate screening for early diagnosis in people living with HIV, initiate antiretroviral treatment, and reduce hospital admissions. This abstract is funded by: None