Frequency and risk factors of infectious complications in neutropenic patients infected with HIV.
OBJECTIVE
To determine causes, incidence and factors associated with infections in neutropenic [polymorphonuclear neutrophil (PMN), 1000 x 10(6)/l] HIV-infected patients.


METHODS
Prospective study.


METHODS
Infectious disease service of a 1000-bed university teaching hospital in Paris, France.


METHODS
HIV-infected patients with a PMN count of < 1000 x 10(6)/l confirmed on two occasions were included in the study. Baseline characteristics, cause of neutropenia and occurrence of infectious episodes were analysed.


RESULTS
The cause of neutropenia was lymphoma in four cases (6.5%), antineoplastic chemotherapy in seven (11.3%), zidovudine in 32 (51%), trimethoprim-sulphamethoxazole (TMP-SMX) in 28 (45%) and ganciclovir in 11 (18%). Fifteen patients (24%) developed infectious complications. Neutropenia induced by chemotherapy or lymphoma was more frequently complicate by infectious episodes (P = 0.02). Neutropenia in the previous 3 months (P = 0.05), presence of a central venous catheter (P = 0.05) and a trough PMN count (P = 0.02) were the three risk factors of infection retained in a logistic model.


CONCLUSIONS
Neutropenia induced by zidovudine, gangiclovir or TMP-SMX, are less complicated by infectious episodes than neutropenia induced by antineoplastic chemotherapy. Overall, infectious episodes in neutropenic HIV-infected patients appear lower than in patients with haemobiologic malignancies.
Meynard
J L
JL
Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, Paris, France.
Guiguet
M
M
Arsac
S
S
Frottier
J
J
Meyohas
M C
MC
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000453:epidemiology*; D019380:Anti-HIV Agents / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications / Q000209:etiology*; D011446:Prospective Studies; D012307:Risk Factors
D019380:Anti-HIV Agents; D000970:Antineoplastic Agents