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Outcomes in HIV-infected patients admitted due to pandemic influenza.

Identifieur interne : 000310 ( Main/Exploration ); précédent : 000309; suivant : 000311

Outcomes in HIV-infected patients admitted due to pandemic influenza.

Auteurs : José L Pez-Aldeguer [Espagne] ; José A. Iribarren ; Eulalia Valencia ; Elena Barquilla ; Hernando Knobel ; Jesús Santos ; Fernando Lozano

Source :

RBID : pubmed:22459686

Descripteurs français

English descriptors

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 χ(2) 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.


DOI: 10.1016/j.eimc.2012.02.007
PubMed: 22459686


Affiliations:


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Le document en format XML

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<b>PURPOSE</b>
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<p>To determine the clinical, epidemiological and prognostic factors of HIV-infected patients with influenza A H1N1 admitted to hospital.</p>
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<p>
<b>METHODS</b>
</p>
<p>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 χ(2) 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.</p>
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<p>
<b>RESULTS</b>
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<p>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).</p>
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<p>
<b>CONCLUSIONS</b>
</p>
<p>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.</p>
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<AbstractText Label="PURPOSE" NlmCategory="OBJECTIVE">To determine the clinical, epidemiological and prognostic factors of HIV-infected patients with influenza A H1N1 admitted to hospital.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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 χ(2) 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.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="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).</AbstractText>
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<LastName>Jesús Bustinduy</LastName>
<ForeName>María</ForeName>
<Initials>M</Initials>
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<Investigator ValidYN="Y">
<LastName>Knobel</LastName>
<ForeName>Hernando</ForeName>
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<LastName>Cervero Jiménez</LastName>
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<Day>28</Day>
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<PubMedPubDate PubStatus="accepted">
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<name sortKey="Knobel, Hernando" sort="Knobel, Hernando" uniqKey="Knobel H" first="Hernando" last="Knobel">Hernando Knobel</name>
<name sortKey="Lozano, Fernando" sort="Lozano, Fernando" uniqKey="Lozano F" first="Fernando" last="Lozano">Fernando Lozano</name>
<name sortKey="Santos, Jesus" sort="Santos, Jesus" uniqKey="Santos J" first="Jesús" last="Santos">Jesús Santos</name>
<name sortKey="Valencia, Eulalia" sort="Valencia, Eulalia" uniqKey="Valencia E" first="Eulalia" last="Valencia">Eulalia Valencia</name>
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<country name="Espagne">
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<name sortKey="L Pez Aldeguer, Jose" sort="L Pez Aldeguer, Jose" uniqKey="L Pez Aldeguer J" first="José" last="L Pez-Aldeguer">José L Pez-Aldeguer</name>
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</record>

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