TY - JOUR
T1 - Severe bacterial non-aids infections in HIV-positive persons
T2 - incidence rates and risk factors
AU - Søgaard, O S
AU - Reekie, J
AU - Ristola, M
AU - Jevtovic, D
AU - Karpov, I
AU - Beniowski, M
AU - Servitskiy, S
AU - Domingo, P
AU - Reiss, P
AU - Mocroft, A
AU - Kirk, O
N1 - Copyright © 2013 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
PY - 2013/5
Y1 - 2013/5
N2 - 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.
AB - 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.
U2 - 10.1016/j.jinf.2012.12.012
DO - 10.1016/j.jinf.2012.12.012
M3 - Journal article
C2 - 23353671
SN - 0163-4453
VL - 66
SP - 439
EP - 446
JO - Journal of Infection
JF - Journal of Infection
IS - 5
ER -