PT - JOURNAL ARTICLE AU - Catia Cilloniz AU - Encarna Moreno AU - Jacobo Sellares AU - Rosanel Amaro AU - Eva Polverino AU - Mar Ortega AU - Albert Gabarrus AU - Asuncion Moreno AU - Jose Maria Miro AU - Josep Mensa AU - Antoni Torres TI - Community acquired lung respiratory infections in HIV-infected patients: Microbial etiology and outcome DP - 2013 Sep 01 TA - European Respiratory Journal PG - P290 VI - 42 IP - Suppl 57 4099 - http://erj.ersjournals.com/content/42/Suppl_57/P290.short 4100 - http://erj.ersjournals.com/content/42/Suppl_57/P290.full SO - Eur Respir J2013 Sep 01; 42 AB - Background: The aim of this study are to examined the correlation of CD4+ cell count and HIV-RNA level with the etiology of CAP in hospitalized HIV-infected patientsMethods: Prospective observational study of consecutive adult patients with HIV infection seen in the ED with the diagnosis of CAP.Results: We studied 331 HIV patients with CAP, mean age of 42.1 ± 9.5 yrs. Mean CD4+ cell count 281.3 ± 248.3 /mm3. 128 (39%) patients had CD4+ cell count lower than 200/mm3. The mean HIV-RNA level 234,236 ± 905,6 copies/ml. 83(25%) patients had HIV-RNA level <50 copies/ml. HIV infection had been diagnosed prior hospital admission in 274 (83%) patients and 57(17%) patients the diagnosis of HIV infection was in the episode of pneumonia. Independent predictors of bacterial CAP in multivariate analysis were days of symptoms ≤5 (OR 2.6), C-reactive protein level ≥22 mg/dl (OR 4.3), and co-infection with HCV (OR 2.3). Current smoker (OR 0.2) or ex-smoker (OR 0.2, 95% CI 0.04-0.8), previous antibiotic (OR 3.5), C-reactive protein level <22 mg/dl (OR 12.5), WBC count ≤4,000 x109 cell/L (OR 3.9), LDH ≥450 U/L (OR 13.1), and multilobar affectation (OR 5.3) were independent predictors of pneumocystic CAP in the multivariate analysis. LDH ≥450 U/L (OR 4.3) and mechanical ventilation (OR 22.6) were the only variables independently associated with 30-day hospital mortality.Conclusion: Bacterial pneumonia was significantly higher than pneumonia for P. jiroveci. S. pneumoniae continues been the main pathogens involved in CAP, regard CD4+ cell count stratus and HIV-RNA levels. Our result indicated there are several risk factors to help us recognise bacterial from Pneumocystic infections.