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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pneumonia in HIV-infected Persons</title><author><name sortKey="Gordin, Fred M" sort="Gordin, Fred M" uniqKey="Gordin F" first="Fred M." last="Gordin">Fred M. Gordin</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Veterans Affairs Medical Center and George Washington University, Washington, DC;</nlm:aff></affiliation></author><author><name sortKey="Roediger, Mollie P" sort="Roediger, Mollie P" uniqKey="Roediger M" first="Mollie P." last="Roediger">Mollie P. Roediger</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota;</nlm:aff></affiliation></author><author><name sortKey="Girard, Pierre Marie" sort="Girard, Pierre Marie" uniqKey="Girard P" first="Pierre-Marie" last="Girard">Pierre-Marie Girard</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Service des Maladies Infectieuses et Tropicales–Hôpital Saint-Antoine, Université Pierre et Marie Curie, and Institut Médecine et d'Epidémiologie Appliquée, Paris, France;</nlm:aff></affiliation></author><author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Copenhagen HIV Programme, University of Copenhagen, Copenhagen, Denmark;</nlm:aff></affiliation></author><author><name sortKey="Miro, Jose M" sort="Miro, Jose M" uniqKey="Miro J" first="Jose M." last="Miro">Jose M. Miro</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Hospital Clinic–Institut d'Investigacions Biomèdiques August Pi-Sunyer, University of Barcelona, Barcelona, Spain;</nlm:aff></affiliation></author><author><name sortKey="Palfreeman, Adrian" sort="Palfreeman, Adrian" uniqKey="Palfreeman A" first="Adrian" last="Palfreeman">Adrian Palfreeman</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University Hospitals of Leicester, Leicester, and Medical Research Council, London, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="Rodriguez Barradas, Maria C" sort="Rodriguez Barradas, Maria C" uniqKey="Rodriguez Barradas M" first="Maria C." last="Rodriguez-Barradas">Maria C. Rodriguez-Barradas</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas;</nlm:aff></affiliation></author><author><name sortKey="Wolff, Marcelo J" sort="Wolff, Marcelo J" uniqKey="Wolff M" first="Marcelo J." last="Wolff">Marcelo J. Wolff</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University of Chile School of Medicine and Arriaran Foundation, Santiago, Chile;</nlm:aff></affiliation></author><author><name sortKey="Easterbrook, Philippa J" sort="Easterbrook, Philippa J" uniqKey="Easterbrook P" first="Philippa J." last="Easterbrook">Philippa J. Easterbrook</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Department of HIV and Genitourinary Medicine, Kings College, London, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="Clezy, Kate" sort="Clezy, Kate" uniqKey="Clezy K" first="Kate" last="Clezy">Kate Clezy</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University of New South Wales, Sydney, Australia;</nlm:aff></affiliation></author><author><name sortKey="Slater, Leonard N" sort="Slater, Leonard N" uniqKey="Slater L" first="Leonard N." last="Slater">Leonard N. Slater</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University of Oklahoma College of Medicine and Veterans Affairs Medical Center, Oklahoma City, Oklahoma</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18617640</idno><idno type="pmc">2542436</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2542436</idno><idno type="RBID">PMC:2542436</idno><idno type="doi">10.1164/rccm.200804-617OC</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000F37</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F37</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Pneumonia in HIV-infected Persons</title><author><name sortKey="Gordin, Fred M" sort="Gordin, Fred M" uniqKey="Gordin F" first="Fred M." last="Gordin">Fred M. Gordin</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Veterans Affairs Medical Center and George Washington University, Washington, DC;</nlm:aff></affiliation></author><author><name sortKey="Roediger, Mollie P" sort="Roediger, Mollie P" uniqKey="Roediger M" first="Mollie P." last="Roediger">Mollie P. Roediger</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota;</nlm:aff></affiliation></author><author><name sortKey="Girard, Pierre Marie" sort="Girard, Pierre Marie" uniqKey="Girard P" first="Pierre-Marie" last="Girard">Pierre-Marie Girard</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Service des Maladies Infectieuses et Tropicales–Hôpital Saint-Antoine, Université Pierre et Marie Curie, and Institut Médecine et d'Epidémiologie Appliquée, Paris, France;</nlm:aff></affiliation></author><author><name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Copenhagen HIV Programme, University of Copenhagen, Copenhagen, Denmark;</nlm:aff></affiliation></author><author><name sortKey="Miro, Jose M" sort="Miro, Jose M" uniqKey="Miro J" first="Jose M." last="Miro">Jose M. Miro</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Hospital Clinic–Institut d'Investigacions Biomèdiques August Pi-Sunyer, University of Barcelona, Barcelona, Spain;</nlm:aff></affiliation></author><author><name sortKey="Palfreeman, Adrian" sort="Palfreeman, Adrian" uniqKey="Palfreeman A" first="Adrian" last="Palfreeman">Adrian Palfreeman</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University Hospitals of Leicester, Leicester, and Medical Research Council, London, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="Rodriguez Barradas, Maria C" sort="Rodriguez Barradas, Maria C" uniqKey="Rodriguez Barradas M" first="Maria C." last="Rodriguez-Barradas">Maria C. Rodriguez-Barradas</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas;</nlm:aff></affiliation></author><author><name sortKey="Wolff, Marcelo J" sort="Wolff, Marcelo J" uniqKey="Wolff M" first="Marcelo J." last="Wolff">Marcelo J. Wolff</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University of Chile School of Medicine and Arriaran Foundation, Santiago, Chile;</nlm:aff></affiliation></author><author><name sortKey="Easterbrook, Philippa J" sort="Easterbrook, Philippa J" uniqKey="Easterbrook P" first="Philippa J." last="Easterbrook">Philippa J. Easterbrook</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">Department of HIV and Genitourinary Medicine, Kings College, London, United Kingdom;</nlm:aff></affiliation></author><author><name sortKey="Clezy, Kate" sort="Clezy, Kate" uniqKey="Clezy K" first="Kate" last="Clezy">Kate Clezy</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University of New South Wales, Sydney, Australia;</nlm:aff></affiliation></author><author><name sortKey="Slater, Leonard N" sort="Slater, Leonard N" uniqKey="Slater L" first="Leonard N." last="Slater">Leonard N. Slater</name><affiliation><nlm:aff id="N0x24c73c0N0x20e81f0">University of Oklahoma College of Medicine and Veterans Affairs Medical Center, Oklahoma City, Oklahoma</nlm:aff></affiliation></author></analytic><series><title level="j">American Journal of Respiratory and Critical Care Medicine</title><idno type="ISSN">1073-449X</idno><idno type="eISSN">1535-4970</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Rationale</italic>: Bacterial pneumonia is a major cause of morbidity for HIV-infected persons and contributes to excess mortality in this population.</p><p><italic>Objectives</italic>: To evaluate the frequency and risk factors for occurrence of bacterial pneumonia in the present era of potent antiretroviral therapy.</p><p><italic>Methods</italic>: We evaluated data from a randomized trial of episodic antiretroviral therapy. The study, Strategies for Management of Antiretroviral Therapy, enrolled 5,472 participants at 318 sites in 33 countries. Study patients had more than 350 CD4 cells at baseline. Diagnosis of bacterial pneumonia was confirmed by a blinded clinical-events committee.</p><p><italic>Measurements and Main Results</italic>: During a mean follow-up of 16 months, 116 participants (2.2%) developed at least one episode of bacterial pneumonia. Patients randomized to receive episodic antiretroviral therapy were significantly more likely to develop pneumonia than patients randomized to receive continuous antiretroviral therapy (hazard ratio, 1.55; 95% confidence interval, 1.07–2.25; <italic>P</italic> = 0.02). Cigarette smoking was a major risk factor: Current-smokers had more than an 80% higher risk of pneumonia compared with never-smokers (hazard ratio, 1.82; 95% confidence interval, 1.09–3.04; <italic>P</italic> = 0.02). Participants who were on continuous HIV treatment and were current smokers were three times more likely to develop bacterial pneumonia than nonsmokers. Current smoking status was significant, but a past history of smoking was not.</p><p><italic>Conclusions</italic>: Bacterial pneumonia is a major source of morbidity, even for persons on potent antiretroviral therapy, including those with high CD4 cells. Efforts to reduce this illness should stress the importance of uninterrupted antiretroviral therapy and attainment and/or maintenance of nonsmoking status.</p><p>Clinical trial registered with <ext-link ext-link-type="uri" xlink:href="www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link> (NCT 00027352).</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Am J Respir Crit Care Med</journal-id><journal-id journal-id-type="publisher-id">ajrccm</journal-id><journal-title>American Journal of Respiratory and Critical Care Medicine</journal-title><issn pub-type="ppub">1073-449X</issn><issn pub-type="epub">1535-4970</issn><publisher><publisher-name>American Thoracic Society</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18617640</article-id><article-id pub-id-type="pmc">2542436</article-id><article-id pub-id-type="publisher-id">ajrccm1786630</article-id><article-id pub-id-type="doi">10.1164/rccm.200804-617OC</article-id><article-categories><subj-group subj-group-type="heading"><subject>E. Pulmonary Infections</subject></subj-group></article-categories><title-group><article-title>Pneumonia in HIV-infected Persons</article-title><subtitle>Increased Risk with Cigarette Smoking and Treatment Interruption</subtitle></title-group><contrib-group><contrib contrib-type="author"><name><surname>Gordin</surname><given-names>Fred M.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">1</xref></contrib><contrib contrib-type="author"><name><surname>Roediger</surname><given-names>Mollie P.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">2</xref></contrib><contrib contrib-type="author"><name><surname>Girard</surname><given-names>Pierre-Marie</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">3</xref></contrib><contrib contrib-type="author"><name><surname>Lundgren</surname><given-names>Jens D.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">4</xref></contrib><contrib contrib-type="author"><name><surname>Miro</surname><given-names>Jose M.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">5</xref></contrib><contrib contrib-type="author"><name><surname>Palfreeman</surname><given-names>Adrian</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">6</xref></contrib><contrib contrib-type="author"><name><surname>Rodriguez-Barradas</surname><given-names>Maria C.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">7</xref></contrib><contrib contrib-type="author"><name><surname>Wolff</surname><given-names>Marcelo J.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">8</xref></contrib><contrib contrib-type="author"><name><surname>Easterbrook</surname><given-names>Philippa J.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">9</xref></contrib><contrib contrib-type="author"><name><surname>Clezy</surname><given-names>Kate</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">10</xref></contrib><contrib contrib-type="author"><name><surname>Slater</surname><given-names>Leonard N.</given-names></name><xref ref-type="aff" rid="N0x24c73c0N0x20e81f0">11</xref></contrib></contrib-group><aff id="N0x24c73c0N0x20e81f0"><label>1</label>Veterans Affairs Medical Center and George Washington University, Washington, DC;<label>2</label>Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota;<label>3</label>Service des Maladies Infectieuses et Tropicales–Hôpital Saint-Antoine, Université Pierre et Marie Curie, and Institut Médecine et d'Epidémiologie Appliquée, Paris, France;<label>4</label>Copenhagen HIV Programme, University of Copenhagen, Copenhagen, Denmark;<label>5</label>Hospital Clinic–Institut d'Investigacions Biomèdiques August Pi-Sunyer, University of Barcelona, Barcelona, Spain;<label>6</label>University Hospitals of Leicester, Leicester, and Medical Research Council, London, United Kingdom;<label>7</label>Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas;<label>8</label>University of Chile School of Medicine and Arriaran Foundation, Santiago, Chile;<label>9</label>Department of HIV and Genitourinary Medicine, Kings College, London, United Kingdom;<label>10</label>University of New South Wales, Sydney, Australia;<label>11</label>University of Oklahoma College of Medicine and Veterans Affairs Medical Center, Oklahoma City, Oklahoma</aff><author-notes><fn><p>Correspondence and requests for reprints should be addressed to Fred M. Gordin, M.D., Chief, Infectious Diseases (151B), Veterans Affairs Medical Center, 50 Irving Street, NW, Washington, DC 20422. E-mail: <email>fred.gordin@med.va.gov</email>.</p></fn></author-notes><pub-date pub-type="ppub"><day>15</day><month>9</month><year>2008</year></pub-date><pub-date pub-type="epub"><day>10</day><month>7</month><year>2008</year></pub-date><volume>178</volume><issue>6</issue><fpage>630</fpage><lpage>636</lpage><history><date date-type="received"><day>25</day><month>4</month><year>2008</year></date><date date-type="accepted"><day>2</day><month>7</month><year>2008</year></date></history><permissions><copyright-statement>Copyright © 2008, American Thoracic Society</copyright-statement></permissions><self-uri xlink:title="pdf" xlink:href="AJRCCM1786630.pdf"></self-uri><abstract><p><italic>Rationale</italic>: Bacterial pneumonia is a major cause of morbidity for HIV-infected persons and contributes to excess mortality in this population.</p><p><italic>Objectives</italic>: To evaluate the frequency and risk factors for occurrence of bacterial pneumonia in the present era of potent antiretroviral therapy.</p><p><italic>Methods</italic>: We evaluated data from a randomized trial of episodic antiretroviral therapy. The study, Strategies for Management of Antiretroviral Therapy, enrolled 5,472 participants at 318 sites in 33 countries. Study patients had more than 350 CD4 cells at baseline. Diagnosis of bacterial pneumonia was confirmed by a blinded clinical-events committee.</p><p><italic>Measurements and Main Results</italic>: During a mean follow-up of 16 months, 116 participants (2.2%) developed at least one episode of bacterial pneumonia. Patients randomized to receive episodic antiretroviral therapy were significantly more likely to develop pneumonia than patients randomized to receive continuous antiretroviral therapy (hazard ratio, 1.55; 95% confidence interval, 1.07–2.25; <italic>P</italic> = 0.02). Cigarette smoking was a major risk factor: Current-smokers had more than an 80% higher risk of pneumonia compared with never-smokers (hazard ratio, 1.82; 95% confidence interval, 1.09–3.04; <italic>P</italic> = 0.02). Participants who were on continuous HIV treatment and were current smokers were three times more likely to develop bacterial pneumonia than nonsmokers. Current smoking status was significant, but a past history of smoking was not.</p><p><italic>Conclusions</italic>: Bacterial pneumonia is a major source of morbidity, even for persons on potent antiretroviral therapy, including those with high CD4 cells. Efforts to reduce this illness should stress the importance of uninterrupted antiretroviral therapy and attainment and/or maintenance of nonsmoking status.</p><p>Clinical trial registered with <ext-link ext-link-type="uri" xlink:href="www.clinicaltrials.gov">www.clinicaltrials.gov</ext-link> (NCT 00027352).</p></abstract><kwd-group><kwd>pneumonia</kwd><kwd>smoking</kwd><kwd>HIV</kwd><kwd>bacterial infections</kwd></kwd-group></article-meta><notes><fn-group><fn><p>Supported by The National Institute of Allergy and Infectious Diseases, National Institutes of Health (U01AI042170 and U01AI46362).</p></fn><fn><p>Originally Published in Press as DOI: 10.1164/rccm.200804-617OC on July 10, 2008</p></fn><fn><p><bold><italic>Conflict of Interest Statement</italic>:</bold> F.M.G. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. M.P.R. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. P.M.G. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. J.D.L. has received funds from Abbott, Bristol-Myers Squibb, Roche, Tibotec, Gilead, GlaxoSmithKline, Pfizer, Merck, and Boehringer Ingelheim for delivering lectures, for consulting, and for clinical trials. J.M.M. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. A.P. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. M.C.R.B. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. M.J.W. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. P.J.E. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. K.C. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript. L.N.S. does not have a financial relationship with a commercial entity that has an interest in the subject of this manuscript.</p></fn></fn-group></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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