Neumonía por Pneumocystis jirovecii en pacientes con VIH y enfermedad avanzada: revisión narrativa

Pneumocystis jirovecii pneumonia remains a relevant opportunistic infection despite antiretroviral therapy and prophylaxis. The study therefore aimed to synthesise recent evidence on the epidemiology, risk factors, diagnosis, treatment and prophylaxis of Pneumocystis jirovecii pneumonia, with emphasis on people with HIV and advanced disease. A narrative review was conducted in PubMed/MEDLINE, Scopus and Web of Science from 2020 to 2025, with a sample of clinical studies, reviews and guidelines. The disease concentrates in late HIV diagnosis with CD4 counts below 200 cells/µL; it is increasing in other immunosuppressed patients with higher mortality; PCR and beta-D-glucan improve detection without resolving colonisation; and trimethoprim-sulfamethoxazole remains the treatment of choice. It was concluded that early HIV diagnosis and targeted prophylaxis are decisive.