Open AccessMutations in the Dihydropteroate Synthase Gene of Human‐DerivedPneumocystis cariniiIsolates from Italy Are Infrequent but Correlate with Prior Sulfa Prophylaxis
Author(s) -
Liang Ma,
Joseph A. Kovacs,
Antonietta Cargnel,
Antonella Valerio,
Giovanna Fantoni,
Chiara Atzori
Publication year - 2002
Publication title -
the journal of infectious diseases (online. university of chicago press)/the journal of infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.69
H-Index - 252
eISSN - 1537-6613
pISSN - 0022-1899
DOI - 10.1086/340220
Subject(s) - dhps , dihydropteroate synthase , pneumocystis carinii , biology , virology , gene mutation , medicine , gene , mutation , genetics , immunology , human immunodeficiency virus (hiv) , pyrimethamine , pneumocystis jirovecii , chloroquine , plasmodium falciparum , malaria
Mutations in the human-derived Pneumocystis carinii dihydropteroate synthase (DHPS) gene have been reported with increasing frequency and have been linked to prior sulfa prophylaxis and possible emergence of sulfa resistance. This study was done to examine the prevalence and clinical significance of P. carinii DHPS mutations in Italian patients. A previously described single-strand conformation polymorphism technique was used to identify P. carinii DHPS mutations in 107 patients with acquired immunodeficiency syndrome. Overall prevalence (8%) was low compared with that in other reports. Mutations were observed in 19% (6/31) of patients exposed to sulfa prophylaxis, compared with 4% (3/76) of patients not exposed to sulfa prophylaxis (P=.017). No significant association was observed between the presence of DHPS mutations and mortality, CD4 cell count, or demographic factors. The study confirms the association between DHPS mutations and prior sulfa prophylaxis and shows that the prevalence of DHPS mutations in an Italian patient population is lower than that in other populations.