Severe bacterial non-aids infections in HIV-positive persons: incidence rates and risk factors.
OBJECTIVE
This study aimed to determine incidence rates (IR) and identify risk factors for severe bacterial non-AIDS infections (SBnAI) requiring hospital admission.


METHODS
Data from the prospective EuroSIDA cohort were utilized to determine IRs of first diagnosis of the following SBnAI requiring hospital admission: bacteremia, endocarditis, meningitis, peritonitis, pneumonia, osteitis, and pyolonephritis. Incidence rate-ratios (IRRs) and risk factors were assessed by Poisson regression.


RESULTS
During 35,839 person-years of follow-up (PYFU), 275 patients were diagnosed with SBnAI (IR = 7.67 per 1000 PYFU, 95% confidence interval: 6.79-8.64). The most frequent infections were pneumonia (IR = 5.36, 4.63-6.17), bacteremia (IR = 1.14, 0.82-1.55), and pyelonephritis (IR = 0.67, 0.43-1.00). A strong risk factor for SBnAI was reduced estimated glomerular filtration rate [eGFR] (adjusted IRR = 5.07, 2.12-12.1 and IRR = 2.73, 1.63-4.56 for eGFR ≤ 60 and 60.1-90 compared to eGFR > 90, respectively). No current combined antiretroviral therapy (cART) compared with current cART use increased the risk of SBnAI (adjusted IRR = 2.96, 2.03-4.32). Other risk factors for SBnAI included current CD4+ count <350 cells/μL, female gender, age, infection with HIV through IDU, prior AIDS diagnosis, and anaemia.


CONCLUSIONS
Enhanced attention directed towards people with comorbidity is warranted to limit the burden of these infections.
Department of Infectious Diseases, Aarhus University Hospital - Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. olesoega@rm.dk
O S
OS
Søgaard
J
J
Reekie
M
M
Ristola
D
D
Jevtovic
I
I
Karpov
M
M
Beniowski
S
S
Servitskiy
P
P
Domingo
P
P
Reiss
A
A
Mocroft
O
O
Kirk
D000328:Adult; D001118:Argentina / Q000453:epidemiology; D001424:Bacterial Infections / Q000453:epidemiology* / Q000821:virology*; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000382:microbiology*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D011446:Prospective Studies; D012307:Risk Factors