RT Journal Article
SR Electronic
T1 Prognostic factors of 30 day mortality in HIV infected patients with community-acquired pneumonia
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P254
VO 44
IS Suppl 58
A1 Raquel Marçôa
A1 Margarida Dias
A1 Daniel Coutinho
A1 Margarida Mota
A1 Miguel Guimarães
A1 Teresa Shiang
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P254.abstract
AB Background: Community-acquired pneumonia (CAP) is a frequent respiratory complication in HIV-infected (HIV+) patients even in the highly active antiretroviral therapy (HAART) era. HIV+ patients are 25 times more likely to develop pneumonia.Purpose: The aim of this study was to determine the prognostic factors of 30 day mortality in CAP in HIV+ patients.Methods: We carried out a retrospective study that included all HIV+ patients with CAP admitted in Department of Infectious Diseases of a Portuguese central hospital between January 2012 and December 2013. Socio-demographic variables, comorbidities, smoking status, CD4+ cell count, HAART status, laboratory and radiologic findings were recorded.Results: We included 51 patients: mean age 44.0±9.6 years, 90.2% men. Overall 30 day mortality was 23.5% (n=12). All non-survivors had CD4+<200/mm3 and were smokers; 83.1% were not on HAART and in 75% CURB65 score was <3. Predictors of mortality were CURB65≥3 (OR 9.8; p=0.011); severe sepsis/septic shock (OR 7.6; p<0.001), neurologic disease (OR 4.01; p=0.013) and CD4+<200/mm3 (OR 1.4; p=0.038). There were no statistical differences between survivors and non-survivors regarding chronic hepatitis, pack-years of smoking, HAART status, duration of HIV infection, C-reactive protein, leucocyte count, radiologic features and microbiologic isolates.Conclusions: Almost one quarter of HIV+ patients with CAP died. Mortality was higher in patients with severe sepsis, CD4+<200/mm3, neurologic disease or CURB65≥3, which should point us to a more aggressive treatment. We also highlight that 75% of non-survivors had CURB65<3 which calls into question the usefulness of low scores in HIV+ patients.