Risk factors, nutritional status, and quality of life in HIV-infected patients with enteric salmonellosis.
OBJECTIVE
To define the potential risk factors, prognostic indicators, and quality of life of HIV-infected patients with enteric salmonellosis.


METHODS
A five-year matched (1:2) case-control study was performed. Thirty cases and 60 matched controls were studied.


RESULTS
Univariate analysis (p < 0.05) identified six risk factors for enteric salmonellosis: 1) increasing value of APACHE II score, 2) altered nutritional status, 3) previous antibiotic therapy, 4) ingestion of "risk" foods, 5) multiple (> or = 2) previous opportunistic infections, 6) stage C of HIV infection. Using the multivariate analysis, the most powerful predictors for developing an enteric salmonellosis were: increasing value of APACHE II score and altered nutritional status. The response to therapy was favourable in all episodes. Five (17%) patients suffered from one or more relapses. Multivariate analysis identified that a low number of circulating CD4+ (< 100/mm3) and a high APACHE II score (> 15) predict an increased risk of relapses.


CONCLUSIONS
HIV-associated enteric salmonellosis occurs more frequently in patients with advanced stage of HIV infection and with impaired nutritional status. We stress the need for a prompt and accurate diagnosis and treatment since the possible haematogenous spread and relapses appear reduced under early and prolonged antibiotic therapy.
Department of Infectious Diseases, Catholic University, Rome, Italy.
E
E
Tacconelli
M
M
Tumbarello
G
G
Ventura
F
F
Leone
R
R
Cauda
L
L
Ortona
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D016001:Confidence Intervals; D003967:Diarrhea / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D004751:Enteritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012480:Salmonella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D012720:Severity of Illness Index
D000900:Anti-Bacterial Agents