[Bacterial pneumonia as a risk marker for new bacterial diseases in patients with HIV infection].
BACKGROUND
Bacterial pneumonias are a main cause of morbidity and mortality among patients infected by the HIV. Furthermore, recent data suggest that, under certain circumstances, they can be prognostic markers.


METHODS
The evolution of a cohort of HIV-infected patients, prospectively defined by having suffered a pneumonia, was studied with regards to the occurrence of a new pneumonia or death from a bacterial disease; the evolution of a control cohort of patients matched according to sex, CD4-cell count, previous HIV-disease and zidovudine-treatment was compared to the former cohort by means of survival-analysis techniques.


RESULTS
Forty-nine patients in each group were followed up for a total of 1389 and 1893 patient-months respectively. In the first group, 17 new first pneumonia episodes were diagnosed, as compared to 7 in the second group (relative-risk: 3.23, 95% confidence interval: 1.34 to 7.79, p = 0.005). Eight of the 31 deaths that occurred in the first group were attributed to a bacterial disease, as compared to none of the 24 deaths in the second group (p = 0.007, Fisher's exact test) (in five of those cases, a bacteria was isolated which was thought to be directly related to the death).


CONCLUSIONS
HIV-infected patients who suffer a bacterial pneumonia have an increased risk of suffering new severe bacterial diseases (pneumonia or fatal diseases) as compared to HIV-infected patients with similar prognostic features but no previous episodes of pneumonia.
Teira
R
R
Sección de Enfermedades Infecciosas, Hospital de Basurto, Bilbao.
Virosta
M
M
Zubero
Z
Z
Baraia-Etxaburu
J
J
Muñoz
J
J
Cisterna
R
R
Santamaría
J M
JM
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology*; D018791:CD4 Lymphocyte Count; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018410:Pneumonia, Bacterial / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015215:Zidovudine / Q000627:therapeutic use
D000998:Antiviral Agents; D015215:Zidovudine
Neumonías bacterianas como marcador de riesgo de nuevas enfermedades bacterianas en pacientes infectados por el HIV.