Bacterial Community Acquired Pneumonia in HIV-Infected Inpatients in the Highly Active Antiretroviral Therapy Era

Madeddu, Giordano; Porqueddu, Elisabetta Maria; Cambosu, Francesca; Saba, Franca; Fois, Alessandro Giuseppe; Pirina, Pietro; Mura, María Stella

doi:10.1007/s15010-007-7162-0

Cited by 51 publications

(52 citation statements)

References 23 publications

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“…Studies investigating aetiological agents in CAP have found pneumococci to be the cause of around 30-40% of cases of CAP among people with HIV infection [14,41]. PPV-23 covers $ 70% of the serotypes causing CAP [42] and $ 90% of serotypes causing IPD [6,14,43,44].…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of pneumococcal polysaccharide vaccination in HIV-infected adults: a systematic review

et al. 2010

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ObjectiveThe effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV-23) in preventing pneumococcal disease in HIV-infected people is a subject of debate. We reviewed the clinical evidence for recommending PPV-23 for use in HIV-infected patients. MethodsA systematic search of peer-reviewed publications (EMBASE, the Cochrane Library, and PubMed/ BioMed Central), the Internet and grey literature was conducted. Three hundred and eighteen documents were reviewed. Studies reporting risk estimates for all-cause pneumonia, allpneumococcal disease, and/or invasive pneumococcal disease after PPV-23 immunization in HIV-infected adults were included. ResultsWe identified one randomized trial and 15 observational studies. While the randomized trial found a 60% increased risk of all-cause pneumonia among vaccinees, 11 of the 15 observational studies found various degrees of disease protection associated with PPV-23 immunization. However, most studies suffered from limited confounder control in their multivariate analyses, despite study data suggesting substantial differences between the characteristics of exposed and unexposed individuals. ConclusionsThe current clinical evidence provides only moderate support for PPV-23 immunization of HIVinfected adults. More data are needed on the efficacy of newer conjugated pneumococcal vaccines, which may be more immunogenic and could potentially replace PPV-23 in the future.

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Section: Discussionmentioning

confidence: 99%

The effectiveness of pneumococcal polysaccharide vaccination in HIV-infected adults: a systematic review

et al. 2010

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“…Pulmonary infections Community-acquired pneumonia It is well recognised that smoking is an independent and eminently preventable risk factor for the development of CAP in both HIV-infected and -uninfected individuals [13,[93][94][95][96][97][98][99]. In HIV-infected patients, the increased risk for CAP, which is evident at all levels of immunosuppression, is estimated to be between two-and five-fold, increasing as the CD4 cell count declines [13,100].…”

Section: Clinical Consequences Of the Cumulative Effects Of Hiv Infecmentioning

confidence: 99%

Impact of HIV infection and smoking on lung immunity and related disorders

2015

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HIV-infected persons not only have higher rates of smoking than the general population, but are also unusually vulnerable to the associated adverse health effects, both infective and noninfective in origin. Indeed, in the setting of well-organised care and availability of highly active antiretroviral therapy, HIV-infected smokers lose more life-years to smoking than to HIV infection per se, presenting a major challenge to healthcare providers. Not surprisingly, the respiratory system is particularly susceptible to the damaging interactive chronic inflammatory and immunosuppressive effects of HIV and smoking, intensifying the risk of the development of opportunistic infections, as well as lung cancer and obstructive lung disorders. The impact of smoking on the immunopathogenesis and frequencies of these respiratory conditions in the setting of HIV infection, as well as on the efficacy of antiretroviral therapy, represent the primary focus of this review. @ERSpublications Smoking exacerbates the immunosuppressive/pro-inflammatory effects of HIV, increasing the risk of pulmonary disease

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“…Similar to that in the general population, Streptococcus pneumoniae and Haemophilus species are the most frequently identified causes of community-acquired bacterial pneumonia (Hirschtick et al, 1995;Madeddu et al, 2008;Schneider, 1999). Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa account for most of the remainder of cases (Afessa & Green, 2000;Baron & Hollander, 1993;Madeddu et al, 2008). Risk factors for S. aureus include recent viral or influenza infection and use of injection drugs.…”

Section: Bacterial Infectionsmentioning

confidence: 98%

“…Other risk factors are a low socioeconomic, alcohol abuse status, comorbidities (including cardiovascular, renal disease malnutrition, and hepatic cirrhosis), low CD4 cell counts (<200 cells/ml), uncontrolled HIV replication and not receiving ART (Madeddu et al, 2010). Similar to that in the general population, Streptococcus pneumoniae and Haemophilus species are the most frequently identified causes of community-acquired bacterial pneumonia (Hirschtick et al, 1995;Madeddu et al, 2008;Schneider, 1999). Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa account for most of the remainder of cases (Afessa & Green, 2000;Baron & Hollander, 1993;Madeddu et al, 2008).…”

Section: Bacterial Infectionsmentioning

confidence: 99%