Etiology, clinical, and epidemiological characteristics of severe respiratory infection in people living with HIV

People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospit...

Full description

Saved in:
Bibliographic Details
Published in:International journal of STD & AIDS 2020-02, Vol.31 (2), p.100-108
Main Authors: Pecego, AC, Amâncio, RT, Costa, DM, Bozza, FA, Siqueira, MM, Oliveira, ML, Cerbino-Neto, J, Japiassu, A
Format: Article
Language:English
Subjects:
Adult
AIDS/HIV
Bacterial Infections - complications
HIV Infections - complications
HIV Infections - virology
Humans
Immunocompromised Host
Inpatients
Male
Opportunistic Infections - immunology
Opportunistic Infections - microbiology
Original s
Prospective Studies
Respiratory Tract Infections - etiology
Respiratory Tract Infections - immunology
Virus Diseases - complications
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:People living with HIV (PLWH) are more prone to severe respiratory infections. We used the severe acute respiratory infection (SARI) definition to describe the etiology, clinical, and epidemiological characteristics in this population. This was a prospective observational study including PLWH hospitalized with fever and cough. Those with symptom onset up to 10 days were classified as severe acute respiratory infection and 11–30 days as non-severe acute respiratory infection. Blood, urine samples and nasopharyngeal swabs were collected. Data were extracted from patient charts during their hospital stay. Forty-nine patients were included, median CD4 cell count: 80 cells/mm3, median time since HIV diagnosis and hospital admission: 84 months and 80% were antiretroviral therapy exposed. Twenty-seven patients were classified as SARI. Etiology was identified in 69%, 47% were polymicrobial. Respiratory virus (9 SARI vs. 13 non-SARI), bacteria (5 SARI vs. 4 non-SARI), Mycobacterium tuberculosis (6 SARI group vs. 7 non-SARI group), Pneumocystis jirovecii (4 SARI vs. 1 non-SARI), Cryptococcus neoformans (1 SARI vs. 3 non-SARI), and influenza A (1 SARI vs. 2 non-SARI). Dyspnea was statistically more prevalent in SARI (78% vs. 36%, p = 0.011) but the risk of death was higher in the non-SARI (4% vs. 36%, p = 0.0067). In the severely immunocompromised PLWH, severe acute respiratory infection can be caused by multiple pathogens and codetection is a common feature.
ISSN:0956-4624
1758-1052
DOI:10.1177/0956462419882587