Outcomes in HIV-infected patients admitted due to pandemic influenza

José López-Aldeguer*, José A. Iribarren, Eulalia Valencia, Elena Barquilla, Hernando Knobel, Jesús Santos, Fernando Lozano

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)

Abstract

Purpose: To determine the clinical, epidemiological and prognostic factors of HIV-infected patients with influenza A H1N1 admitted to hospital. Methods: The study population was HIV infected patients with confirmed influenza infection admitted to hospital in a multicenter cohort. We analyzed demographic data, comorbid conditions, severe events (bronchopneumonia, respiratory insufficiency, respiratory distress, sepsis, admission to intensive care unit, death) and outcome. Data were analyzed using descriptive statistics. Proportions were compared using the χ2 test or Fisher exact test, when applicable. Quantitative variables were compared using the Student t test or Mann-Whitney test. Prognostic impact was analyzed using logistic regression. Results: A total of 43 patients, of whom 62.8% were male, were included from 22 hospitals. The mean age was 43.3 years (interquartile range [IQR], 38.4-48.4). HIV was diagnosed for a mean of 14.5 years (IQR, 8.4-20.3). CD4 lymphocyte was <200 cells/μL in 38%; 85.7% were on antiretroviral therapy, and 66.7% virologically suppressed. Comorbid conditions were hepatitis B or C (74.4%), smoking (67.4%), chronic obstructive pulmonary disease (30.2%), asthma (14%), and obesity (8.6%). Seven patients had received seasonal influenza vaccination, and 2 the H1N1 vaccine. Cough (100%), fever (93%), gastrointestinal disorders (27.9%) or general - myalgia, general malaise - (67.4%) were the presenting symptoms. These were severe in 24 (55.8%) with 7 (16.3%) requiring intensive care. Two patients died. A lower CD4 lymphocyte count was associated with bacterial infection (P =.063) and longer hospital stay (P =.007). Early oseltamivir reduced severe cases (OR, 4.5; 1.1-18.3; P =.035). Conclusions: HIV-infected patients admitted to hospital due to influenza A H1N1 had severe morbidity. Low CD4 lymphocytes correlated with longer hospitalization and bacterial infections. Early oseltamivir treatment reduced severe symptoms.

Original languageAmerican English
Pages (from-to)608-612
Number of pages5
JournalEnfermedades Infecciosas y Microbiologia Clinica
Volume30
Issue number10
DOIs
Publication statusPublished - Dec 2012

Keywords

  • HIV infection
  • Influenza A H1N1
  • Pandemic influenza
  • Prognostic factors

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