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

O S Søgaard; J Reekie; M Ristola; D Jevtovic; I Karpov; M Beniowski; S Servitskiy; P Domingo; P Reiss; A Mocroft; O Kirk

doi:10.1016/j.jinf.2012.12.012

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

O S Søgaard, J Reekie, M Ristola, D Jevtovic, I Karpov, M Beniowski, S Servitskiy, P Domingo, P Reiss, A Mocroft, O Kirk

Department of Clinical Medicine

29 Citations (Scopus)

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.

Original language	English
Journal	Journal of Infection
Volume	66
Issue number	5
Pages (from-to)	439-46
Number of pages	8
ISSN	0163-4453
DOIs	https://doi.org/10.1016/j.jinf.2012.12.012
Publication status	Published - May 2013

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10.1016/j.jinf.2012.12.012

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title = "Severe bacterial non-aids infections in HIV-positive persons: incidence rates and risk factors",

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.",

author = "S{\o}gaard, {O S} and J Reekie and M Ristola and D Jevtovic and I Karpov and M Beniowski and S Servitskiy and P Domingo and P Reiss and A Mocroft and O Kirk",

year = "2013",

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doi = "10.1016/j.jinf.2012.12.012",

language = "English",

volume = "66",

pages = "439--46",

journal = "Journal of Infection",

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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

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 -

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

Abstract

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