[Study of 164 episodes of infectious endocarditis in drug addicts: comparison of HIV positive and negative patients].
OBJECTIVE
Intravenous drug-addicts (IVDA) are the most important risk group for acquiring HIV and developing infective endocarditis (IE) in Spain. The clinical and evolutive features of a large series of IE in HIV-infected IVDA are reported and compared with those observed in a smaller group of patients without HIV infection.


METHODS
A retrospective analysis was made of 164 episodes of IE from 136 patients diagnosed in a Service of Infectious Diseases in Madrid (1986-1992). IE was defined according to the modified Von Reyn criteria and only the probable and definite IE episodes were evaluated.


RESULTS
A total of 143 IE episodes occurred in 117 IVDA infected with HIV (group A) and 21 episodes in 19 HIV-negative patients (group B). Most of seropositive patients were asymptomatic carriers of HIV (54%) and only 22% had AIDS. The IE onset was acute for 97% patients in group A and 81% in group B, with fever and respiratory symptoms as main complaints. Chest X-ray was normal in 19% of cases in group A and in 28% in group B. Septic embolisms were observed in 56% and 41% of patients in group A and B, respectively. The vegetation originated mainly on the tricuspid valve and Staphylococcus aureus was recovered from most blood-cultures. The mortality rate was similar in both groups, 6% and 5% in groups A and B, respectively.


CONCLUSIONS
Most IVDA with IE were HIV-positive patients in this series. IE is usually reported in the early stages of HIV infection and apparently its presence has no influence on the clinical course of IE.
Valencia
M E
ME
Servicio de Enfermedades Infecciosas, CIC, Instituto de Salud Carlos III, Madrid.
Guinea
J
J
Soriano
V
V
Martínez
M L
ML
Moreno
V
V
Laguna
F
F
Enríquez
A
A
González Lahoz
J
J
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000150:complications; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006679:HIV Seropositivity / Q000097:blood / Q000150:complications; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications*
Estudio de 164 episodios de endocarditis infecciosa en drogadictos: comparación entre pacientes VIH positivos y negativos.