Pneumonia and influenza hospitalization in HIV-positive seniors.
HIV-positive persons and the elderly have increased risk for influenza-related complications, including pneumonia. Using claims data for pneumonia and influenza (P&I) hospitalization in the USA, we described the temporo-demographic trends and in-patient case-fatality in persons aged ≥ 65 years by HIV status. Our results showed a near doubling in the fraction of P&I admissions representing HIV-positive persons between 1991 and 2004 [relative risk (RR) 1·95, 95% confidence interval (CI) 1·80-2·13]. HIV-positive adults were younger (70·3 vs. 79·9 years, P<0·001), and had higher case-fatality (18·0% vs. 12·6%, P<0·001). Adjusting for other variables, case-fatality decreased by 5·8% in HIV-positive persons with the availability of highly active antiretroviral therapy (P=0·032). However, HIV-positive seniors were still 51% more likely to die during hospitalization than HIV-negative persons in 2004 (OR 1·51, 95% CI 1·23-1·85). HIV-infected persons represent a growing fraction of the elderly population hospitalized with P&I. Additional measures are needed to reduce case-fatality associated with P&I in this population.
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA.
S M
SM
Mor
J A
JA
Aminawung
A
A
Demaria
E N
EN
Naumova
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D007251:Influenza, Human / Q000401:mortality*; D008297:Male; D011014:Pneumonia / Q000401:mortality*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology