title: Community-Acquired Pneumococcal Pneumonia in Virologically Suppressed HIV-Infected Adult Patients: A Matched Case-Control Study.
abstract: The study aimed to investigate whether the clinical presentations and outcomes (length of stay, ICU admission, and 30-day mortality) of pneumococcal pneumonia in virologically suppressed patients who were HIV-infected on ART with a CD4+ T-cell count > 350 cells/mm3are comparable to those seen in patients with HIV, using a case-control design.
  
  
  
  A case-control study was carried out in Hospital Clinic, Barcelona, Spain (2001-2016). Control patients were matched by age (±10 years), sex, comorbidities, and pneumonia diagnosis in the same calendar period. Clinical presentation and outcomes of pneumococcal pneumonia in patients who were and were not infected with HIV were compared.
  
  
  
  Pneumococcal pneumonia was studied in 50 cases (HIV infection) and 100 control patients (non-HIV infection). Compared with the control patients, case patients had higher rates of influenza (14% vs 2%, P = .007) and pneumococcal vaccination (10% vs 1%, P = .016). The group of cases also presented a higher rate of coinfection with hepatitis B virus (6% vs 0%, P = .036). Both groups presented similar ICU admission (18% vs 27%, P = .22), need for mechanical ventilation (12% vs 8%; P = .43), length of stay (7 days vs 7 days, P = .76), and 0% of 30-day mortality. No evidence was found of a more severe presentation or a worse clinical outcome in cases than in control patients.
  
  
  
  Pneumococcal pneumonia episodes requiring hospitalization in virologically suppressed patients with HIV with > 350 CD4+ T-cell count/mm3were neither more severe nor had worse prognosis compared with uninfected patients. These results support the fact that such patients do not need treatment, admission, or care sites different to the general population.
  
  
  
  ClinicalTrials.gov; No. 2009/5451; URL: www.clinicaltrials.gov.
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Ciber de Enfermedades Respiratorias (Ciberes) Barcelona, Spain.
authors.forename: Catia
authors.initials: C
authors.lastname: Cillóniz
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Ciber de Enfermedades Respiratorias (Ciberes) Barcelona, Spain. Electronic address: atorres@clinic.ub.es.
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
authors.affiliation: Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Christian
authors.initials: C
authors.lastname: Manzardo
authors.affiliation: Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Ciber de Enfermedades Respiratorias (Ciberes) Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Gabarrús
authors.affiliation: Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Ambrosioni
authors.affiliation: Infectología de Adultos, Hospital General Regional nº1, Instituto Mexicano del Seguro Social, Tijuana, BC, Mexico.
authors.forename: Adriana
authors.initials: A
authors.lastname: Salazar
authors.affiliation: Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: García
authors.affiliation: Seccion Neumología, Hospital Nacional Alejandro Posadas, Palomar, Argentina.
authors.forename: Adrián
authors.initials: A
authors.lastname: Ceccato
authors.affiliation: Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Mensa
authors.affiliation: Department of Microbiology, Hospital Clinic of Barcelona, Barcelona, Spain.
authors.forename: Jorge Puig
authors.initials: JP
authors.lastname: de la Bella Casa
authors.affiliation: Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Asunción
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Miró
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes; D016022:Case-Control Studies; D060085:Coinfection / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D017714:Community-Acquired Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D003422:Critical Care / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D015497:HIV-1; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011018:Pneumonia, Pneumococcal / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents
keywords: HIV-infected patients; community-acquired pneumonia; pneumonia