title: Elevated risk for invasive meningococcal disease among persons with HIV.
abstract: BACKGROUND
  An association between HIV and invasive meningococcal disease (IMD) has been suggested by several previous studies but has not been fully described in the era of highly active antiretroviral therapy in the United States.
  
  
  OBJECTIVE
  To estimate the risk for IMD and death in people living with HIV/AIDS (PLWHA) in New York City (NYC) and the contribution of CD4(+) cell count and viral load (VL) to IMD risk.
  
  
  METHODS
  Comparison of the incidence rate of IMD among PLWHA with that among HIV-uninfected persons. Surveillance data on IMD for patients aged 15 to 64 years from 2000 to 2011 were matched to death and HIV registries to calculate IMD risk and case-fatality ratios. A subset of PLWHA who had a CD4(+) cell count and VL measurement near the time of their IMD infection was included in age-matched case-control analyses to assess HIV markers and IMD risk.
  
  
  METHODS
  Retrospective cohort from communicable disease surveillance.
  
  
  METHODS
  265 persons aged 15 to 64 years with IMD during 2000 to 2011.
  
  
  METHODS
  Meningococcal and HIV data abstracted from surveillance and registry databases, including CD4(+) cell counts and VL.
  
  
  RESULTS
  The average annual incidence rate of IMD was 0.39 cases per 100 000 persons. The relative risk for IMD among PLWHA in NYC during 2000 to 2011 was 10.0 (95% CI, 7.2 to 14.1). Among PLWHA, patients with IMD were 5.3 times (CI, 1.4 to 20.4 times) as likely as age-matched control patients to have CD4(+) counts less than 0.200 × 10(9) cells/L.
  
  
  CONCLUSIONS
  Missing data on smoking status and comorbidity.
  
  
  CONCLUSIONS
  People living with HIV/AIDS in NYC are at increased risk for IMD. Cost-effectiveness and vaccine efficacy studies are needed to evaluate the value of a national recommendation for routine meningococcal vaccination of PLWHA.
  
  
  BACKGROUND
  New York City Tax Levy.
authors.forename: Laura
authors.initials: L
authors.lastname: Miller
authors.forename: Lola
authors.initials: L
authors.lastname: Arakaki
authors.forename: Arianne
authors.initials: A
authors.lastname: Ramautar
authors.forename: Sara
authors.initials: S
authors.lastname: Bodach
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Braunstein
authors.forename: Joseph
authors.initials: J
authors.lastname: Kennedy
authors.forename: Linda
authors.initials: L
authors.lastname: Steiner-Sichel
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ngai
authors.forename: Colin
authors.initials: C
authors.lastname: Shepard
authors.forename: Don
authors.initials: D
authors.lastname: Weiss
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000821:virology; D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D022401:Meningococcal Vaccines / Q000627:therapeutic use; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines