tetano
Editor, Senior Moderator
AIDS. 2010 Dec 6. [Epub ahead of print]
Severe 2009 pandemic influenza A (H1N1) infection and increased mortality in patients with late and advanced HIV disease.
Ormsby CE, Rosa-Zamboni DD, V?zquez-P?rez J, Ablanedo-Terrazas Y, Vega-Barrientos R, G?mez-Palacio M, Murakami-Ogasawara A, Ibarra-?valos JA, Romero-Rodr?guez D, Avila-R?os S, Reyes-Ter?n G.
From the Center for Research in Infectious Diseases (CIENI) of the National Institute of Respiratory Diseases in Mexico (INER).
Abstract
OBJECTIVES: Describe the clinical course of infection by 2009 (H1N1) influenza virus in different stages of HIV-disease.
DESIGN: Prospective, observational study.
METHODS: During the pandemic period, HIV-infected patients presenting respiratory symptoms at a third level referral hospital in Mexico City were tested for 2009 influenza A (H1N1) viral RNA. Clinical files were prospectively analyzed.
RESULTS: Infection by H1N1 was confirmed in 30 (23.8%) of the total 126 HIV infected patients studied. In the group of patients with 2009 H1N1 virus infection, 16 (53.3%) were hospitalized, 12 (40%) had active opportunistic infections and 6 (20%) died. In the group of 96 patients not infected with 2009 H1N1 virus, 54 (56.25%) were hospitalized with opportunistic infections and 12 (12.5%) died. For all hospitalized patients, being on HAART and having undetectable HIV viral loads at hospitalization was associated with higher survival (p = 0.019). Patients with 2009 H1N1 virus infection had a higher mortality rate, even after adjusting for HAART (p = 0.043). Coinfection by HIV and H1N1 2009 virus was more severe in patients with opportunistic infections, as shown by longer hospital stays (p = 0.0013), higher rates of hospitalization (p < 0.0001), use of mechanical ventilation (p = 0.0086), and death (p = 0.026). Delayed administration of oseltamivir in hospitalized patients was significantly associated with mortality (p = 0.0022).
CONCLUSION: Our data suggest that infection by 2009 H1N1 is more severe in HIV infected patients with late and advanced HIV disease than in well controlled patients under HAART.
PMID: 21139486 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21139486
Severe 2009 pandemic influenza A (H1N1) infection and increased mortality in patients with late and advanced HIV disease.
Ormsby CE, Rosa-Zamboni DD, V?zquez-P?rez J, Ablanedo-Terrazas Y, Vega-Barrientos R, G?mez-Palacio M, Murakami-Ogasawara A, Ibarra-?valos JA, Romero-Rodr?guez D, Avila-R?os S, Reyes-Ter?n G.
From the Center for Research in Infectious Diseases (CIENI) of the National Institute of Respiratory Diseases in Mexico (INER).
Abstract
OBJECTIVES: Describe the clinical course of infection by 2009 (H1N1) influenza virus in different stages of HIV-disease.
DESIGN: Prospective, observational study.
METHODS: During the pandemic period, HIV-infected patients presenting respiratory symptoms at a third level referral hospital in Mexico City were tested for 2009 influenza A (H1N1) viral RNA. Clinical files were prospectively analyzed.
RESULTS: Infection by H1N1 was confirmed in 30 (23.8%) of the total 126 HIV infected patients studied. In the group of patients with 2009 H1N1 virus infection, 16 (53.3%) were hospitalized, 12 (40%) had active opportunistic infections and 6 (20%) died. In the group of 96 patients not infected with 2009 H1N1 virus, 54 (56.25%) were hospitalized with opportunistic infections and 12 (12.5%) died. For all hospitalized patients, being on HAART and having undetectable HIV viral loads at hospitalization was associated with higher survival (p = 0.019). Patients with 2009 H1N1 virus infection had a higher mortality rate, even after adjusting for HAART (p = 0.043). Coinfection by HIV and H1N1 2009 virus was more severe in patients with opportunistic infections, as shown by longer hospital stays (p = 0.0013), higher rates of hospitalization (p < 0.0001), use of mechanical ventilation (p = 0.0086), and death (p = 0.026). Delayed administration of oseltamivir in hospitalized patients was significantly associated with mortality (p = 0.0022).
CONCLUSION: Our data suggest that infection by 2009 H1N1 is more severe in HIV infected patients with late and advanced HIV disease than in well controlled patients under HAART.
PMID: 21139486 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21139486