RT Journal Article SR Electronic T1 Community-acquired lung respiratory infections in HIV-infected patients: microbial aetiology and outcome JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1698 OP 1708 DO 10.1183/09031936.00155813 VO 43 IS 6 A1 Catia Cilloniz A1 Antoni Torres A1 Eva Polverino A1 Albert Gabarrus A1 Rosanel Amaro A1 Encarnacion Moreno A1 Santiago Villegas A1 Mar Ortega A1 Josep Mensa A1 Maria Angeles Marcos A1 Asuncion Moreno A1 Jose M. Miro YR 2014 UL http://erj.ersjournals.com/content/43/6/1698.abstract AB We describe the aetiology of community-acquired pneumonia (CAP) in HIV-infected patients, risk factors for bacterial or Pneumocystis jirovecii CAP and prognostic factors of 30-day mortality. This was a prospective observational study of 331 consecutive adult CAP cases in HIV-infected patients (January 2007 to July 2012). 128 (39%) patients had CD4+ cell counts <200 per mm3 and 99 (43%) ha HIV RNA levels <200 copies per mL on antiretroviral therapy. Streptococcus pneumoniae was the most frequent microorganism in the group with CD4+ cell counts ≥200 per mm3; P. jirovecii was the most frequent microorganism in the group with CD4+ cell counts <200 per mm3 and in patients with HIV RNA ≥200 copies per mL. Predictors of bacterial CAP were: time with symptoms ≤5 days (OR 2.6, 95% CI 1.5–4.4), C-reactive protein level ≥22 mg·dL−1 (OR 4.3, 95% CI 2.3–8.2) and hepatitis C virus co-infection (OR 2.3, 95% CI 1.4–3.9). White blood cell count ≤4×1012 per L (OR 3.7, 95% CI 1.2–11.5), lactate dehydrogenase (LDH) level ≥598 U·L−1 (OR 12.9, 95% CI 4.2–39.7) and multilobar infiltration (OR 5.8, 95% CI 1.9–19.5) were predictors of P. jirovecii. Overall 30-day mortality was 7%. Appropriate antibiotic treatment (OR 0.1, 95% CI 0.03–0.4), LDH ≥598 U·L−1 (OR 6.2, 95% CI 1.8–21.8) and mechanical ventilation (OR 22.0, 95% CI 6.2–78.6) were the variables independently associated with 30-day mortality. The described predictors may help clinicians to distinguish between bacterial and P. jirovecii pneumonia in patients with suspected or confirmed HIV infection. Clinical risk factors in HIV patients to distinguish between bacterial and Pneumocystis jirovecii pneumonia http://ow.ly/sV2hf