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Pneumocystis jirovecii pneumonia (PCP) is usually diagnosed by direct visualization of the organism in respiratory secretions. Serum levels of (1→3)-β-D-glucan (β-glucan), a component of many fungi, including P. jirovecii, have been found to be elevated in patients with PCP. To assess whether testing blood β-glucan levels might be useful in diagnosing HIV-related PCP, investigators evaluated this assay in HIV-infected patients presenting with a wide variety of opportunistic infections (OIs).
Of 282 participants in ACTG 5164 (PLoS ONE 2009; 4:e5575 and 2010; 5:e11416), 252 had an analyzable β-glucan result. PCP was the most common qualifying OI, occurring in 69% of patients. Other common OIs were cryptococcal meningitis (14%) and bacterial pn…