title: Meningococcal Disease in Patients With Human Immunodeficiency Virus Infection: A Review of Cases Reported Through Active Surveillance in the United States, 2000-2008.
abstract: BACKGROUND
  Although human immunodeficiency virus (HIV) infection is an established risk factor for several bacterial infections, the association between HIV infection and meningococcal disease remains unclear.
  
  
  METHODS
  Expanded chart reviews were completed on persons with meningococcal disease and HIV infection reported from 2000 through 2008 from 9 US sites participating in an active population-based surveillance system for meningococcal disease. The incidence of meningococcal disease among patients meeting Centers for Disease Control and Prevention acquired immune deficiency syndrome (AIDS) surveillance criteria was estimated using data from the National HIV Surveillance System for the participating sites.
  
  
  RESULTS
  Thirty-three cases of meningococcal disease in individuals with HIV infection were reported from participating sites, representing 2.0% of all reported meningococcal disease cases. Most (75.8%) persons with HIV infection were adult males aged 25 to 64 years old. Among all meningococcal disease cases aged 25 to 64 years old, case fatality ratios were similar among HIV-infected and HIV-uninfected persons (13.3% vs 10.6%;P= .6). The cumulative, mean incidence of meningococcal disease among patients aged 25 to 64 years old with HIV infection ever classified as AIDS was 3.5 cases per 100000 person years (95% confidence interval [CI], 2.1-5.6), compared with 0.3 cases per 100000 person years (95% CI, 0.3-0.3) for persons of the same age group not reported to have AIDS (relative risk = 12.9; 95% CI, 7.9-20.9).
  
  
  CONCLUSIONS
  Individuals with HIV infection meeting the AIDS surveillance case definition have a higher incidence of meningococcal disease compared with the general adult population.
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;; Logistics Health Inc., La Crosse, Wisconsin.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Harris
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Henry M
authors.initials: HM
authors.lastname: Wu
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Li
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: H Irene
authors.initials: HI
authors.lastname: Hall
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Adria
authors.initials: A
authors.lastname: Lee
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Zell
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Lee H
authors.initials: LH
authors.lastname: Harrison
authors.affiliation: Connecticut Department of Public Health , Hartford.
authors.forename: Susan
authors.initials: S
authors.lastname: Petit
authors.affiliation: Department of Medicine, Emory University School of Medicine and the Atlanta VA Medical Center , Georgia.
authors.forename: Monica M
authors.initials: MM
authors.lastname: Farley
authors.affiliation: Minnesota Department of Health , St. Paul.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lynfield
authors.affiliation: Colorado Department of Public Health and Environment , Denver.
authors.forename: Lisa
authors.initials: L
authors.lastname: Miller
authors.affiliation: New Mexico Department of Health , Sante Fe.
authors.forename: Megin
authors.initials: M
authors.lastname: Nichols
authors.affiliation: School of Public Health, University of California , Berkeley.
authors.forename: Arthur
authors.initials: A
authors.lastname: Reingold
authors.affiliation: Vanderbilt University School of Medicine , Nashville, Tennessee.
authors.forename: William
authors.initials: W
authors.lastname: Schaffner
authors.affiliation: Oregon Department of Human Services , Portland.
authors.forename: Ann
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: MacNeil
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Clark
authors.affiliation: Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia.
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Cohn
keywords: HIV; disease surveillance; meningitis; meningococcal disease