Risk factors for community-acquired pneumonia among persons infected with human immunodeficiency virus.
Two hundred eleven adults with human immunodeficiency virus (HIV) infection hospitalized for community-acquired pneumonia, including Pneumocystis carinii pneumonia (PCP; patients), and 192 matched HIV-infected hospitalized patients without pneumonia (controls) were interviewed to determine risk factors for pneumonia. Multivariate logistic regression showed that patients were less likely than controls to have used trimethoprim-sulfamethoxazole (TMP-SMZ) prophylaxis (odds ratio [OR], 0.22; 95% confidence interval [CI], 0.12-0.41) and more likely to have been hospitalized previously with pneumonia (OR, 6.25; CI, 3.40-11.5). Patients were also more likely than controls to have gardened (OR, 2.24; CI, 1.00-5.02) and to have camped or hiked (OR, 4.95; CI, 1.31-18.7), but stratified analysis by etiologic agent showed this association only for PCP. These findings reconfirm the efficacy of TMP-SMZ in preventing community-acquired pneumonia. In addition, hospitalization for pneumonia might represent a missed opportunity to encourage HIV-infected patients to enter into regular medical care and to adhere to prescribed antiretroviral and prophylaxis medications.
Navin
T R
TR
Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. trn1@cdc.gov
Rimland
D
D
Lennox
J L
JL
Jernigan
J
J
Cetron
M
M
Hightower
A
A
Roberts
J M
JM
Kaplan
J E
JE
D000328:Adult; D017714:Community-Acquired Infections / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology* / Q000517:prevention & control; D011020:Pneumonia, Pneumocystis / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use
D015662:Trimethoprim, Sulfamethoxazole Drug Combination