title: Legionnaires disease and HIV infection.
abstract: OBJECTIVE
  To compare the outcome of Legionnaires disease (LD) in patients with and without HIV infection.
  
  
  METHODS
  Retrospective review of clinical charts.
  
  
  METHODS
  Six hundred-bed university hospital.
  
  
  METHODS
  We studied the clinical findings of 64 patients without HIV and 15 patients with HIV. Patients with a serologic diagnosis only were not included. Patients with previous immunosuppressive therapy or transplant recipients were excluded from the former group. In the HIV group, the mean CD4 cell count was 347.5/ microL, plasma viral load was undetectable in 50% of the patients, and only one patient (7%) was receiving cotrimoxazole as prophylaxis against Pneumocystis carinii at the time of pneumonia. No differences were observed in the two groups with respect to community or nosocomial acquisition, delay in the initiation of appropriate treatment, the use of macrolides or fluoroquinolones, and Fine score in cases of community-acquired LD.
  
  
  RESULTS
  Univariate analysis showed that time to apyrexia was longer, and respiratory symptoms, bilateral infiltrates in chest radiograph, hyponatremia, increase in aspartate aminotransferase and creatine phosphokinase (CK), and respiratory failure were more frequent in the HIV group. Mortality was greater in patients with HIV, achieving a statistically significant value of 20%; however, multivariate analysis only confirmed these differences with respect to the increase in CK.
  
  
  CONCLUSIONS
  LD has a more severe clinical presentation and worse evolution in patients with HIV.
authors.affiliation: Infectious Disease Unit, University Hospital Germans Trias i Pujol, Universitat Autònoma, Badalona, Spain. mlpbotet@ns.hugtip.scs.es
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Pedro-Botet
authors.forename: Miquel
authors.initials: M
authors.lastname: Sabrià
authors.forename: Nieves
authors.initials: N
authors.lastname: Sopena
authors.forename: Marian
authors.initials: M
authors.lastname: García-Núñez
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Dominguez
authors.forename: Esteban
authors.initials: E
authors.lastname: Reynaga
authors.forename: Celestino
authors.initials: C
authors.lastname: Rey-Joly
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007877:Legionnaires' Disease / Q000150:complications / Q000401:mortality; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000188:drug therapy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D019562:Viral Load
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination