Non-HIV pneumocystis pneumonia

Human immunodeficiency virus (HIV)-uninfected Pneumocystis jirovecii pneumonia (non-HIV PCP) can develop in patients with autoimmune diseases, malignancies, and other diseases, and it can lead to potentially lethal respiratory dysfunction showing a high mortality (1–3). Over the past decade, a paradigm shift in the treatment of autoimmune disease such as rheumatoid arthritis (RA) (4, 5) and inflammatory bowel diseases (IBD) has been brought about by the introduction of biologics (6–8). While the emergence of innovative biologic agents targeted at specific molecules and pathways in the immune system have altered the clinical course of autoimmune disease patients and improved their quality of lives and social outcomes, increasing incidence of non-HIV PCP have been noticed (4–8). In the field of solid organ transplant recipients and malignancies, the emergence of new generation of immunosuppressive agents, such as rituximab and cytotoxic agents could result in frequent occurrence of non-HIV PCP (9–13). Today, although every clinician could encounter PCP patients, there is no established standard treatment for non-HIV PCP. We review recent topics and some aspects to improve the treatment of non-HIV PCP.