Abstract
This study of Pneumocystis carinii dihydropteroate synthase (DHPS) mutations in patients with AIDS who have P. carinii pneumonia compares the change in the prevalence of such mutations in the United States, where sulfa-drug prophylaxis is widespread, to that in China, where it is infrequent. The DHPS gene from 145 US patients presenting during 1983-2001 and from 15 Chinese patients presenting during 1998-2001 was amplified by polymerase chain reaction and was sequenced. In the United States, 40% of patients had DHPS mutations; 38% received sulfa-drug prophylaxis. Mutation prevalence increased to 70% during 2000-2001, from 25% during 1994-1995 (P<.01). In China, 7% of patients had DHPS mutations; none received sulfa-drug prophylaxis. The prevalence of P. carinii DHPS mutations has markedly increased in the United States but remains low in China.
Publication types
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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AIDS-Related Opportunistic Infections / drug therapy
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AIDS-Related Opportunistic Infections / epidemiology*
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AIDS-Related Opportunistic Infections / microbiology
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Acquired Immunodeficiency Syndrome / complications
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Acquired Immunodeficiency Syndrome / drug therapy
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Acquired Immunodeficiency Syndrome / epidemiology*
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Adult
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Anti-Infective Agents / therapeutic use
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Chemoprevention
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China / epidemiology
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Dapsone / therapeutic use
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Dihydropteroate Synthase / genetics*
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Female
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Humans
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Male
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Middle Aged
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Mutation*
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Pneumocystis carinii / enzymology
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Pneumocystis carinii / genetics*
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Pneumonia, Pneumocystis / drug therapy
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Pneumonia, Pneumocystis / epidemiology*
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Pneumonia, Pneumocystis / microbiology
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Polymerase Chain Reaction
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Prevalence
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
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United States / epidemiology
Substances
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Anti-Infective Agents
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Trimethoprim, Sulfamethoxazole Drug Combination
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Dapsone
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Dihydropteroate Synthase