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J Infect. 2013 May;66(5):439-46. doi: 10.1016/j.jinf.2012.12.012. Epub 2013 Jan 24.

Severe bacterial non-aids infections in HIV-positive persons: incidence rates and risk factors.

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  • 1Department of Infectious Diseases, Aarhus University Hospital - Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. olesoega@rm.dk

Abstract

OBJECTIVES:

This study aimed to determine incidence rates (IR) and identify risk factors for severe bacterial non-AIDS infections (SBnAI) requiring hospital admission.

METHODS:

Data from the prospective EuroSIDA cohort were utilized to determine IRs of first diagnosis of the following SBnAI requiring hospital admission: bacteremia, endocarditis, meningitis, peritonitis, pneumonia, osteitis, and pyolonephritis. Incidence rate-ratios (IRRs) and risk factors were assessed by Poisson regression.

RESULTS:

During 35,839 person-years of follow-up (PYFU), 275 patients were diagnosed with SBnAI (IR = 7.67 per 1000 PYFU, 95% confidence interval: 6.79-8.64). The most frequent infections were pneumonia (IR = 5.36, 4.63-6.17), bacteremia (IR = 1.14, 0.82-1.55), and pyelonephritis (IR = 0.67, 0.43-1.00). A strong risk factor for SBnAI was reduced estimated glomerular filtration rate [eGFR] (adjusted IRR = 5.07, 2.12-12.1 and IRR = 2.73, 1.63-4.56 for eGFR ≤ 60 and 60.1-90 compared to eGFR > 90, respectively). No current combined antiretroviral therapy (cART) compared with current cART use increased the risk of SBnAI (adjusted IRR = 2.96, 2.03-4.32). Other risk factors for SBnAI included current CD4+ count <350 cells/μL, female gender, age, infection with HIV through IDU, prior AIDS diagnosis, and anaemia.

CONCLUSIONS:

Enhanced attention directed towards people with comorbidity is warranted to limit the burden of these infections.

PMID:
23353671
DOI:
10.1016/j.jinf.2012.12.012
[PubMed - indexed for MEDLINE]
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