title: Methicillin-resistant Staphylococcus aureus (MRSA) infections among HIV-infected persons in the era of highly active antiretroviral therapy: a review of the literature.
abstract: OBJECTIVE
  Despite the rise of methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) among HIV-infected persons during the era of highly active antiretroviral therapy (HAART), the precise relationship between these two infections has not been fully elucidated. Therefore, we provide a comprehensive, literature-based review of MRSA infections among HIV-infected persons.
  
  
  METHODS
  A systematic search of MEDLINE using the search terms "HIV" and "MRSA" identified references published during the HAART era (January 1996 to January 2011). Relevant articles on MRSA in the general population were also reviewed for comparison.
  
  
  RESULTS
  The most common type of MRSA infection among HIV-infected persons is SSTI caused by USA300, Panton-Valentine leukocidin (PVL)-positive strains. HIV-infected persons have an increased risk for both initial MRSA infections and recurrent infections compared with the general population. Risk factors for MRSA infections in this population include immunosuppression, comorbid conditions and certain lifestyle behaviours such as high-risk sexual behaviours and illicit drug use. Further research is needed on the optimal treatment and prevention strategies for MRSA infections among HIV-infected persons.
  
  
  CONCLUSIONS
  HIV-infected persons have a propensity for MRSA SSTI and a high rate of recurrent disease. The reasons for the elevated rates of MRSA infections among HIV-infected persons appear to be multifactorial, but may be mitigated with optimized HIV control and reductions in associated risk factors.
authors.affiliation: Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Shadyab
authors.forename: N F
authors.initials: NF
authors.lastname: Crum-Cianflone
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D023241:Antiretroviral Therapy, Highly Active; D055030:Drug Users / Q000706:statistics & numerical data; D005260:Female; D015497:HIV-1 / Q000276:immunology / Q000302:isolation & purification*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000276:immunology / Q000302:isolation & purification*; D012307:Risk Factors; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D014481:United States / Q000453:epidemiology