{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:10:40Z","timestamp":1787760640688,"version":"build-2784847793"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/open-government-licence\/version\/2\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pneumocystis pneumonia (PCP) is a life-threatening but treatable and preventable fungal infection in immunocompromised persons. Previous studies suggest that persons without HIV who develop PCP (PCPHIV-) experience more acute, severe illness than persons with HIV who develop PCP (PCPHIV+). We analyzed health insurance claims data to compare demographics, underlying conditions, symptoms, and prescriptions for PCPHIV+\u2005and PCPHIV-.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used the IBM MarketScan Research Databases to identify patients diagnosed with PCP during 2011\u20132015. We analyzed claims 1 year before to 3 months after diagnosis to compare PCPHIV+\u2005and PCPHIV-.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 3938 patients, 70.4% were PCPHIV-. Compared with PCPHIV+, PCPHIV- were more likely to be older (median, 60 vs 45 years; P\u2005&amp;lt;\u2005.0001), female (51.5% vs 20.2%; P\u2005&amp;lt;\u2005.0001), hypoxemic (13.5% vs 7.1%; P\u2005&amp;lt;\u2005.0001), and to die within 90 days (6.6% vs 4.2%; P\u2005&amp;lt;\u2005.0001). The most common underlying conditions among PCPHIV- included chronic pulmonary diseases (54.6%), solid tumors (35.1%), hematologic malignancies (20.1%), and rheumatologic conditions (14.0%). The median time between the first visit for PCP-related symptoms and PCP diagnosis was longer for PCPHIV- than PCPHIV+\u2005(25 vs 16 days; P\u2005&amp;lt;\u2005.0001). In the 3 months before PCP diagnosis, PCPHIV- were less likely to have an outpatient prescription for PCP prophylaxis than PCPHIV+\u2005(6.9% vs 10.6%; P\u2005=\u2005.0001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PCPHIV- may experience a prolonged illness course and diagnostic delays compared with PCPHIV+. Clinicians should maintain a high index of suspicion for PCP in immunocompromised patients with compatible symptoms, regardless of HIV status.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaa255","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T12:13:51Z","timestamp":1593432831000},"source":"Crossref","is-referenced-by-count":16,"title":["Possible Diagnostic Delays and Missed Prevention Opportunities in Pneumocystis Pneumonia Patients Without HIV: Analysis of Commercial Insurance Claims Data\u2014United States, 2011\u20132015"],"prefix":"10.1093","volume":"7","author":[{"given":"Jeremy A W","family":"Gold","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan R","family":"Jackson","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Benedict","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,29]]},"reference":[{"key":"2020071807262775900_CIT0001","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/334519a0","article-title":"Ribosomal RNA sequence shows Pneumocystis carinii to be a member of the fungi","volume":"334","author":"Edman","year":"1988","journal-title":"Nature"},{"key":"2020071807262775900_CIT0002","doi-asserted-by":"crossref","first-page":"891","DOI":"10.3201\/eid0809.020096","article-title":"A new name (Pneumocystis jiroveci) for Pneumocystis from humans","volume":"8","author":"Stringer","year":"2002","journal-title":"Emerg Infect Dis"},{"key":"2020071807262775900_CIT0003","doi-asserted-by":"crossref","first-page":"83","DOI":"10.7326\/0003-4819-80-1-83","article-title":"Pneumocystis carinii pneumonia in the United States. 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