{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T07:04:23Z","timestamp":1791097463506,"version":"4.1.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2012,11,16]],"date-time":"2012-11-16T00:00:00Z","timestamp":1353024000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"DOI":"10.1371\/journal.pone.0049991","type":"journal-article","created":{"date-parts":[[2012,11,16]],"date-time":"2012-11-16T22:30:39Z","timestamp":1353105039000},"page":"e49991","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":26,"title":["Low Prevalence of Pneumocystis pneumonia (PCP) but High Prevalence of Pneumocystis dihydropteroate synthase (dhps) Gene Mutations in HIV-Infected Persons in Uganda"],"prefix":"10.1371","volume":"7","author":[{"given":"Steve M.","family":"Taylor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven R.","family":"Meshnick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Worodria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Andama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adithya","family":"Cattamanchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Lucian","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel D.","family":"Yoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Byanyima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Kaswabuli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol D.","family":"Goodman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"International HIV-associated Opportunistic Pneumonias (IHOP) Study","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2012,11,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4269\/ajtmh.2011.10-0640","article-title":"Etiology of suspected pneumonia in adults admitted to a high-dependency unit in Blantyre, Malawi","volume":"85","author":"TK Hartung","year":"2011","journal-title":"Am J Trop Med Hyg"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1001\/archinte.1996.00440020081010","article-title":"A meta-analysis of the relative efficacy and toxicity of Pneumocystis carinii prophylactic regimens","volume":"156","author":"JP Ioannidis","year":"1996","journal-title":"Arch Intern Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1128\/AAC.49.2.741-748.2005","article-title":"Mutations in the Pneumocystis jirovecii DHPS gene confer cross-resistance to sulfa drugs","volume":"49","author":"P Iliades","year":"2005","journal-title":"Antimicrob Agents Chemother"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"2610","DOI":"10.1128\/AAC.48.7.2610-2616.2004","article-title":"Pneumocystis jiroveci dihydropteroate synthase polymorphisms confer resistance to sulfadoxine and sulfanilamide in Saccharomyces cerevisiae","volume":"48","author":"I Meneau","year":"2004","journal-title":"Antimicrob Agents Chemother"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.3201\/eid1010.040362","article-title":"Sulfa use, dihydropteroate synthase mutations, and Pneumocystis jirovecii pneumonia","volume":"10","author":"CR Stein","year":"2004","journal-title":"Emerg Infect Dis"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1051\/parasite\/2010173219","article-title":"Epidemiology and clinical relevance of Pneumocystis jirovecii Frenkel, 1976 dihydropteroate synthase gene mutations","volume":"17","author":"O Matos","year":"2010","journal-title":"Parasite"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/S0140-6736(99)03320-6","article-title":"Effects of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of AIDS-associated P. carinii pneumonia","volume":"354","author":"J Helweg-Larsen","year":"1999","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1086\/315719","article-title":"Pneumocystis carinii mutations are associated with duration of sulfa or sulfone prophylaxis exposure in AIDS patients","volume":"182","author":"P Kazanjian","year":"2000","journal-title":"J Infect Dis"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1128\/JCM.02102-08","article-title":"Clinical significance and phylogenetic relationship of novel Australian Pneumocystis jirovecii genotypes","volume":"47","author":"SJ van Hal","year":"2009","journal-title":"J Clin Microbiol"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1097\/QAI.0b013e3180decbe2","article-title":"Genotyping of Pneumocystis jiroveci pneumonia in Italian AIDS patients. Clinical outcome is influenced by dihydropteroate synthase and not by internal transcribed spacer genotype","volume":"45","author":"A Valerio","year":"2007","journal-title":"J Acquir Immune Defic Syndr"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0140-6736(01)05705-1","article-title":"Effect of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of P carinii pneumonia in patients with HIV-1: a prospective study","volume":"358","author":"TR Navin","year":"2001","journal-title":"Lancet"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1086\/315148","article-title":"Pneumocystis carinii dihydropteroate synthase but not dihydrofolate reductase gene mutations correlate with prior trimethoprim-sulfamethoxazole or dapsone use","volume":"180","author":"L Ma","year":"1999","journal-title":"J Infect Dis"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1086\/340220","article-title":"Mutations in the dihydropteroate synthase gene of human-derived Pneumocystis carinii isolates from Italy are infrequent but correlate with prior sulfa prophylaxis","volume":"185","author":"L Ma","year":"2002","journal-title":"J Infect Dis"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1128\/JCM.02004-09","article-title":"High prevalence of dihydropteroate synthase mutations in Pneumocystis jirovecii isolated from patients with Pneumocystis pneumonia in South Africa","volume":"48","author":"L Dini","year":"2010","journal-title":"J Clin Microbiol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1086\/424010","article-title":"Prevalence of dihydropteroate synthase mutants in HIV-infected South African children with Pneumocystis jiroveci pneumonia","volume":"39","author":"HJ Zar","year":"2004","journal-title":"Clin Infect Dis"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Taylor SM, Meshnick SR, Worodria W, Andama A, Davis JL, <etal>et al<\/etal>.. (2011) Low prevalence of Pneumocystis jirovecii lung colonization in Ugandan HIV-infected patients hospitalized with non-Pneumocystis pneumonia. Diagnostic Microbiology &amp; Infectious Disease.","DOI":"10.1016\/j.diagmicrobio.2011.10.009"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.diagmicrobio.2006.03.010","article-title":"Sensitivity and specificity of nested and real-time PCR for the detection of Pneumocystis jiroveci in clinical specimens","volume":"56","author":"Mr Alvarez-Mart\u00c3\u00adnez","year":"2006","journal-title":"Diagnostic microbiology and infectious disease"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1093\/jac\/dkl411","article-title":"Genetic characterization of the dihydrofolate reductase gene of Pneumocystis jirovecii isolates from Portugal","volume":"58","author":"MC Costa","year":"2006","journal-title":"J Antimicrob Chemother"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/QAI.0b013e3181ce6b19","article-title":"The prevalence and clinical course of HIV-associated pulmonary cryptococcosis in Uganda","volume":"54","author":"S Deok-jong Yoo","year":"2010","journal-title":"J Acquir Immune Defic Syndr"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1183\/09031936.00010210","article-title":"Bronchoscopy is useful for diagnosing smear-negative tuberculosis in HIV-infected patients","volume":"36","author":"W Worodria","year":"2010","journal-title":"Eur Respir J"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1097\/QAD.0b013e3282fdf8bf","article-title":"Clinical features and etiology of pneumonia in acid-fast bacillus sputum smear-negative HIV-infected patients hospitalized in Asia and Africa","volume":"22","author":"M Vray","year":"2008","journal-title":"AIDS"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1164\/ajrccm\/147.3.658","article-title":"Pulmonary complications of human immunodeficiency virus infection in Bujumbura, Burundi","volume":"147","author":"G Kamanfu","year":"1993","journal-title":"Am Rev Respir Dis"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1164\/ajrccm.149.6.8004318","article-title":"Pulmonary disease associated with the human immunodeficiency virus in Kigali, Rwanda. A fiberoptic bronchoscopic study of 111 cases of undetermined etiology","volume":"149","author":"J Batungwanayo","year":"1994","journal-title":"Am J Respir Crit Care Med"},{"key":"ref24","first-page":"420","article-title":"Aetiology and presentation of HIV\/AIDS-associated pulmonary infections in patients presenting for bronchoscopy at a referral hospital in northern Tanzania","volume":"84","author":"GS Kibiki","year":"2007","journal-title":"East Afr Med J"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1080\/00365540701474508","article-title":"Pneumocystis jiroveci pneumonia and other pulmonary infections in TB smear-negative HIV-positive patients with atypical chest X-ray in Ethiopia","volume":"39","author":"G Aderaye","year":"2007","journal-title":"Scandinavian journal of infectious diseases"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1016\/S0140-6736(95)91862-0","article-title":"Pneumocystis carinii pneumonia in Zimbabwe","volume":"346","author":"AS Malin","year":"1995","journal-title":"Lancet"},{"key":"ref27","first-page":"117","article-title":"Causes of lower respiratory infection in HIV-infected Ugandan adults who are sputum AFB smear-negative","volume":"7","author":"W Worodria","year":"2003","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1128\/JCM.28.5.975-979.1990","article-title":"Evaluation of an indirect fluorescent-antibody stain for detection of Pneumocystis carinii in respiratory specimens","volume":"28","author":"VL Ng","year":"1990","journal-title":"J Clin Microbiol"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"2432","DOI":"10.1128\/JCM.28.11.2432-2436.1990","article-title":"Comparison of four methods for rapid detection of Pneumocystis carinii in respiratory specimens","volume":"28","author":"P Cregan","year":"1990","journal-title":"J Clin Microbiol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1086\/315824","article-title":"Sulfa or sulfone prophylaxis and geographic region predict mutations in the Pneumocystis carinii dihydropteroate synthase gene","volume":"182","author":"L Huang","year":"2000","journal-title":"J Infect Dis"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/01.aids.0000168974.67090.70","article-title":"Severity and outcome of HIV-associated Pneumocystis pneumonia containing Pneumocystis jirovecii dihydropteroate synthase gene mutations","volume":"19","author":"K Crothers","year":"2005","journal-title":"AIDS"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1086\/655145","article-title":"Interhuman transmission as a potential key parameter for geographical variation in the prevalence of Pneumocystis jirovecii dihydropteroate synthase mutations","volume":"51","author":"PM Hauser","year":"2010","journal-title":"Clin Infect Dis"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/1475-2875-6-39","article-title":"Diagnosis and treatment of malaria in peripheral health facilities in Uganda: findings from an area of low transmission in south-western Uganda","volume":"6","author":"R Ndyomugyenyi","year":"2007","journal-title":"Malaria Journal"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1080\/13693780701883722","article-title":"Study of DHPS and DHFR genes of Pneumocystis jirovecii in Thai HIV-infected patients","volume":"46","author":"S Siripattanapipong","year":"2008","journal-title":"Med Mycol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"4301","DOI":"10.1128\/AAC.48.11.4301-4305.2004","article-title":"Mutations of Pneumocystis jirovecii dihydrofolate reductase associated with failure of prophylaxis","volume":"48","author":"A Nahimana","year":"2004","journal-title":"Antimicrob Agents Chemother"}],"container-title":["PLoS ONE"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/dx.plos.org\/10.1371\/journal.pone.0049991","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T06:00:02Z","timestamp":1594879202000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0049991"}},"subtitle":[],"editor":[{"given":"Ana Paula","family":"Arez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2012,11,16]]},"references-count":35,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2012,11,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0049991","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,16]]}}}