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Peer-reviewedCC BY 4.0Frontiers in Pharmacology

Efficacy and safety of adjuvant glucocorticoid therapy for Pneumocystis pneumonia (PCP) in patients positive for HIV: a systematic review and meta-analysis

  • Zhiyong Tang1
  • Rui Li2
  • Xiaoying Chen1,3
  • Qiang Su1,3
  • Bin Han2
  • Ming Yang4
4 affiliations
  1. 1Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital
  2. 2The Affiliated Hospital of North Sichuan Medical College
  3. 3Nanchong Key Laboratory of Individualized Drug Therapy
  4. 4Xiamen Humanity Hospital
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Abstract

Objective: To systematically evaluate the efficacy and safety of glucocorticoids as adjuvant therapy for Pneumocystis pneumonia (PCP) in patients positive for human immunodeficiency virus (HIV).

Methods: Clinical randomized controlled trials or clinical controlled trials evaluating the efficacy and safety of glucocorticoids as adjuvant therapy for PCP in patients who are HIV-positive were retrieved from PubMed, Embase, Web of Science, and the Cochrane Library. Data extraction and methodological quality assessment were performed for eligible studies. Meta-analysis and systematic evaluation were conducted using RevMan v.5.1 and STATA v.12.0 software.

Results: Nine articles (13 studies) were included. Compared with the controls, patients treated with glucocorticoids had significantly lower mortality rates (OR = 0.41, 95% CI [0.28–0.59], P < 0.00001), early deterioration rates (OR = 0.08, 95% CI [0.02–0.39], P = 0.002), and lower mechanical ventilation rates (OR = 0.32, 95% CI [0.19–0.55], P < 0.0001). Regarding safety, the incidence of adverse effects did not differ significantly between the two groups (OR = 0.74, 95% CI [0.33–1.70], P = 0.48).

Conclusion: Adjuvant glucocorticoid therapy significantly reduces mortality, early deterioration, and mechanical ventilation rates in patients who are HIV-positive with PCP without increasing adverse reactions. Glucocorticoids may serve as a viable adjuvant treatment option for PCP in patients who are HIV-positive.

Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/home , identifier CRD420261418795.

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Cite

BibTeXRIS
BibTeX
@article{tang2026efficacy,
  title = {{Efficacy and safety of adjuvant glucocorticoid therapy for Pneumocystis pneumonia (PCP) in patients positive for HIV: a systematic review and meta-analysis}},
  author = {Zhiyong Tang and Rui Li and Xiaoying Chen and Qiang Su and Bin Han and Ming Yang},
  journal = {Frontiers in Pharmacology},
  year = {2026},
  month = oct,
  doi = {10.3389/fphar.2026.1916907},
  url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1916907/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Efficacy and safety of adjuvant glucocorticoid therapy for Pneumocystis pneumonia (PCP) in patients positive for HIV: a systematic review and meta-analysis
AU  - Zhiyong Tang
AU  - Rui Li
AU  - Xiaoying Chen
AU  - Qiang Su
AU  - Bin Han
AU  - Ming Yang
PY  - 2026
DA  - 2026/10/28
JO  - Frontiers in Pharmacology
DO  - 10.3389/fphar.2026.1916907
UR  - https://www.frontiersin.org/articles/10.3389/fphar.2026.1916907/full
AB  - Objective: To systematically evaluate the efficacy and safety of glucocorticoids as adjuvant therapy for Pneumocystis pneumonia (PCP) in patients positive for human immunodeficiency virus (HIV).  Methods: Clinical randomized controlled trials or clinical controlled trials evaluating the efficacy and safety of glucocorticoids as adjuvant therapy for PCP in patients who are HIV-positive were retrieved from PubMed, Embase, Web of Science, and the Cochrane Library. Data extraction and methodological quality assessment were performed for eligible studies. Meta-analysis and systematic evaluation were conducted using RevMan v.5.1 and STATA v.12.0 software.  Results: Nine articles (13 studies) were included. Compared with the controls, patients treated with glucocorticoids had significantly lower mortality rates (OR = 0.41, 95% CI [0.28–0.59], P < 0.00001), early deterioration rates (OR = 0.08, 95% CI [0.02–0.39], P = 0.002), and lower mechanical ventilation rates (OR = 0.32, 95% CI [0.19–0.55], P < 0.0001). Regarding safety, the incidence of adverse effects did not differ significantly between the two groups (OR = 0.74, 95% CI [0.33–1.70], P = 0.48).  Conclusion: Adjuvant glucocorticoid therapy significantly reduces mortality, early deterioration, and mechanical ventilation rates in patients who are HIV-positive with PCP without increasing adverse reactions. Glucocorticoids may serve as a viable adjuvant treatment option for PCP in patients who are HIV-positive.  Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/home , identifier CRD420261418795.
SN  - 1663-9812
ER  -