{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:19:46Z","timestamp":1792189186116,"version":"4.4.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"OUH overl\u00e6ger\u00e5dets forskningsfond"},{"name":"Ingemann O. Bucks fond"},{"name":"Preben og Anne Simonsens Fond"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We aimed to examine pneumocystis pneumonia (PCP) risk and mortality among people with human immunodeficiency virus (HIV), and associations with (1) time after HIV diagnosis, (2) calendar time, and (3) CD4 cell count.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From the Danish HIV cohort study, we identified all adult people with HIV (PWH) (1995\u20132021). We estimated incidence rates (IRs) and mortality rates. We used Poisson regression analysis to compute adjusted incidence ratios (IRRs) and mortality rate ratios. PCP risk was assessed according to time after HIV diagnosis, calendar time, and low CD4 cell count.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 4882 PWH (53 647 person-years), we observed 336 PCP events (for the time period 2016\u20132021 compared to 1995\u20131999, PCP risk decreased by &amp;gt;90% after the first year of HIV diagnosis; aIRR, 0.08 [95% confidence interval {CI}, .02\u2013.29], and by &amp;gt;40% in the first year, if baseline CD4 count was &amp;lt;200 cells\/\u00b5L [aIRR, 0.57 [95% CI, .36\u2013.90]). However, no statistically significant change in PCP risk was observed after 1995\u20131999 for the latter group. PCP risk remained high if the CD4 count was 100 to &amp;lt;200 cells\/\u00b5L (IR, 16.08 [95% CI, 5.19\u201349.89]) during the first year of combination antiretroviral therapy (cART), despite a suppressed viral load. Major reductions were found after 1 year of cART (CD4 count 100 to &amp;lt;200 cells\/\u00b5L). Although nonsignificant, the 3- and 12-month mortality rate decreased by 80% from 1995\u20131999 to 2016\u20132021.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PCP remains a significant problem among late presenters with HIV, emphasizing the importance of early HIV diagnosis. Continuing PCP prophylaxis until the CD4 count is &amp;gt;100 cells\/\u00b5L, with at least 1 year of cART and viral suppression for &amp;gt;3 months should be considered; however; further studies are needed to confirm these results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf289","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:21:25Z","timestamp":1747218085000},"source":"Crossref","is-referenced-by-count":4,"title":["Pneumocystis Pneumonia\u2014Is it Still a Threat Among People With Human Immunodeficiency Virus (HIV)? A Danish HIV Cohort Study"],"prefix":"10.1093","volume":"12","author":[{"given":"Anne K","family":"M\u00f8ller","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Research Unit of Infectious Diseases, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine B","family":"Schnoor","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Research Unit of Infectious Diseases, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Research Unit of Infectious Diseases, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Martin-Iguacel","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Research Unit of Infectious Diseases, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitte","family":"Kronborg","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Copenhagen University, Amager-Hvidovre Hospital , Hvidovre ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3963-3804","authenticated-orcid":false,"given":"Carsten S","family":"Larsen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aarhus University Hospital , Aarhus ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dalager-Pedersen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Aalborg University Hospital , Aalborg ,","place":["Denmark"]},{"name":"Department of Clinical Medicine, Aalborg University , Aalborg ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Gerstoft","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars H","family":"Omland","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Rigshospitalet , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0853-0893","authenticated-orcid":false,"given":"Line D","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Odense University Hospital , Odense ,","place":["Denmark"]},{"name":"Research Unit of Infectious Diseases, University of Southern Denmark , Odense ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"2025070415111399200_ofaf289-B1","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1080\/14787210.2017.1364991","article-title":"Treatment of Pneumocystis jirovecii pneumonia in HIV-infected patients: a review","volume":"15","author":"Huang","year":"2017","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2025070415111399200_ofaf289-B2","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1177\/1060028016650107","article-title":"Pneumocystis jirovecii pneumonia in the non-HIV-infected population","volume":"50","author":"Avino","year":"2016","journal-title":"Ann Pharmacother"},{"key":"2025070415111399200_ofaf289-B3","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1080\/14787210.2019.1671823","article-title":"Pneumocystis pneumonia in the twenty-first century: HIV-infected versus HIV-uninfected patients","volume":"17","author":"Cill\u00f3niz","year":"2019","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2025070415111399200_ofaf289-B4","author":"World Health Organization"},{"key":"2025070415111399200_ofaf289-B5","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0140-6736(08)61113-7","article-title":"Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies","volume":"372","author":"Antiretroviral Therapy Cohort Collaboration","year":"2008","journal-title":"Lancet"},{"key":"2025070415111399200_ofaf289-B6","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1093\/infdis\/jiw085","article-title":"Incidence of AIDS-defining opportunistic infections in a multicohort analysis of HIV-infected persons in the United States and Canada, 2000\u20132010","volume":"214","author":"Buchacz","year":"2016","journal-title":"J Infect Dis"},{"key":"2025070415111399200_ofaf289-B7","doi-asserted-by":"crossref","first-page":"749","DOI":"10.7326\/L16-0091","article-title":"Update of survival for persons with HIV infection in Denmark","volume":"165","author":"Lohse","year":"2016","journal-title":"Ann Intern Med"},{"key":"2025070415111399200_ofaf289-B8","author":"Statens Serum Institut"},{"key":"2025070415111399200_ofaf289-B9","author":"Statens Serum Institut"},{"key":"2025070415111399200_ofaf289-B10","first-page":"757135","article-title":"The direct medical costs of late presentation (&lt;350\/mm) of HIV infection over a 15-year period","volume":"2012","author":"Krentz","year":"2012","journal-title":"AIDS Res Treat"},{"key":"2025070415111399200_ofaf289-B11","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1086\/655761","article-title":"Is it safe to discontinue primary Pneumocystis jiroveci pneumonia prophylaxis in patients with virologically suppressed HIV infection and a CD4 cell count &lt;200 cells\/microL?","volume":"51","author":"Mocroft","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2025070415111399200_ofaf289-B12","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/hiv.12878","article-title":"2019 update of the European AIDS Clinical Society guidelines for treatment of people living with HIV version 10.0","volume":"21","author":"Ryom","year":"2020","journal-title":"HIV Med"},{"key":"2025070415111399200_ofaf289-B13","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1093\/cid\/ciaa615","article-title":"Withholding primary pneumocystis pneumonia prophylaxis in virologically suppressed patients with human immunodeficiency virus: an emulation of a pragmatic trial in COHERE","volume":"73","author":"Atkinson","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025070415111399200_ofaf289-B14","author":"Statistics Denmark. Population [in Danish]"},{"key":"2025070415111399200_ofaf289-B15","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1111\/j.1365-2125.2011.03935.x","article-title":"Adherence to national guidelines for initiation of antiretroviral regimens in HIV patients: a Danish nationwide study","volume":"72","author":"Petersen","year":"2011","journal-title":"Br J Clin Pharmacol"},{"key":"2025070415111399200_ofaf289-B16","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1093\/ije\/dyu153","article-title":"Cohort profile update: the Danish HIV Cohort Study (DHCS)","volume":"43","author":"Omland","year":"2014","journal-title":"Int J Epidemiol"},{"issue":"7 Suppl","key":"2025070415111399200_ofaf289-B17","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/1403494810387965","article-title":"The Danish Civil Registration System","volume":"39","author":"Pedersen","year":"2011","journal-title":"Scand J Public Health"},{"key":"2025070415111399200_ofaf289-B18","first-page":"263","article-title":"The Danish National Hospital Register. A valuable source of data for modern health sciences","volume":"46","author":"Andersen","year":"1999","journal-title":"Dan Med Bull"},{"key":"2025070415111399200_ofaf289-B19","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the Charlson Comorbidity Index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am J Epidemiol"},{"key":"2025070415111399200_ofaf289-B20","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1056\/NEJMoa1506816","article-title":"Initiation of antiretroviral therapy in early asymptomatic HIV infection","volume":"373","author":"Lundgren","year":"2015","journal-title":"N Engl J Med"},{"key":"2025070415111399200_ofaf289-B21","doi-asserted-by":"crossref","first-page":"e681","DOI":"10.1097\/MD.0000000000000681","article-title":"Epidemiology and long-term survival in HIV-infected patients with Pneumocystis jirovecii pneumonia in the HAART era: experience in a university hospital and review of the literature","volume":"94","author":"L\u00f3pez-S\u00e1nchez","year":"2015","journal-title":"Medicine (Baltimore)"},{"key":"2025070415111399200_ofaf289-B22","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S1473-3099(17)30303-1","article-title":"Fungal infections in HIV\/AIDS","volume":"17","author":"Limper","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2025070415111399200_ofaf289-B23","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1097\/QAD.0000000000001085","article-title":"Frequency and impact of suboptimal immune recovery on first-line antiretroviral therapy within the International Epidemiologic Databases to Evaluate AIDS in East Africa","volume":"30","author":"Nakanjako","year":"2016","journal-title":"AIDS"},{"key":"2025070415111399200_ofaf289-B24","author":"EuroTEST"},{"key":"2025070415111399200_ofaf289-B25","doi-asserted-by":"crossref","first-page":"100877","DOI":"10.1016\/j.eclinm.2021.100877","article-title":"Current evidence on the adoption of indicator condition guided testing for HIV in Western countries: a systematic review and meta-analysis","volume":"35","author":"Bogers","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2025070415111399200_ofaf289-B26","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/hiv.12735","article-title":"Primary health care: an opportunity for early identification of people living with undiagnosed HIV infection","volume":"20","author":"Martin-Iguacel","year":"2019","journal-title":"HIV Med"},{"key":"2025070415111399200_ofaf289-B27","doi-asserted-by":"crossref","first-page":"1900225","DOI":"10.2807\/1560-7917.ES.2019.24.41.1900225","article-title":"Prescription of antimicrobials in primary health care as a marker to identify people living with undiagnosed HIV infection, Denmark, 1998 to 2016","volume":"24","author":"Martin-Iguacel","year":"2019","journal-title":"Euro Surveill"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofaf289\/63175371\/ofaf289.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/6\/ofaf289\/63175371\/ofaf289.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/12\/6\/ofaf289\/63175371\/ofaf289.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T19:11:22Z","timestamp":1751656282000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofaf289\/8130899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,5,31]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofaf289","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,5,14]]},"article-number":"ofaf289"}}