title: A comparison of HIV-positive patients with and without infective endocarditis: an echocardiographic study--the Emory Endocarditis Group experience.
abstract: OBJECTIVE
  To determine the clinical features in HIV-positive patients with and without infective endocarditis (IE).
  
  
  METHODS
  All bacteremic, HIV-positive patients with suspected IE admitted over a four-year period who underwent either transesophageal echocardiography (TEE) or transthoracic echocardiography (TTE) were retrospectively reviewed with regard to clinical, laboratory, and demographic characteristics.
  
  
  RESULTS
  Ten (11.5%) of 87 HIV-positive patients had a clinical diagnosis of IE based on the Duke Criteria. The mean age of patients with IE was 37.8 years and without IE 39.9 years (P = NS). Both patient groups were similar with respect to gender, race, IVDA, renal failure requiring hemodialysis, history of predisposing heart disease, origin of infection, and causative organism of infection. The mean CD4 count (cells/microL) was 200.7 in patients with IE and 95.9 in patients without IE (P = NS). Of 10 HIV-positive patients with IE, seven had left-sided heart involvement, two had complications related to IE, three required cardiothoracic surgery, and three died.
  
  
  CONCLUSIONS
  There were no differences found with regard to the clinical characteristics of HIV-positive patients with and without IE. No correlation could be drawn between mortality and the degree of immunosuppression in patients from this study. The high incidence of IE (11.5%) and mortality rate (30%) in this study suggests that IE in HIV-positive patients, including non-intravenous drug abusers, represents a real concern for clinicians and their management of these patients.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Dustin T
authors.initials: DT
authors.lastname: Smith
authors.forename: Matthew
authors.initials: M
authors.lastname: Sherwood
authors.forename: Ryan
authors.initials: R
authors.lastname: Crisel
authors.forename: James
authors.initials: J
authors.lastname: Abraham
authors.forename: Craig
authors.initials: C
authors.lastname: Mansour
authors.forename: Emir
authors.initials: E
authors.lastname: Veledar
authors.forename: Robert
authors.initials: R
authors.lastname: Mondschein
authors.forename: Stamatios
authors.initials: S
authors.lastname: Lerakis
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000328:Adult; D018791:CD4 Lymphocyte Count; D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000000981:diagnostic imaging*; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D006435:Renal Dialysis / Q000706:statistics & numerical data; D012307:Risk Factors; D014463:Ultrasonography