Fatal Case of Pneumonia Associated with Pandemic (H1N1) 2009 in HIV-Positive Patient

Klein, Natalie C.; Chak, Azfar; Chengot, Marilyn; Johnson, Diane H.; Cunha, Burke A.

doi:10.3201/eid1601.090930

Cited by 18 publications

(5 citation statements)

References 3 publications

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“…In our cohort, viral shedding lasted a median of 8 and 5 days, measured by RT-PCR and culture, respectively, which was similar to published reports in general populations [17,18]. Because early antiviral treatment with oseltamivir resulted in a significantly shorter duration of viral shedding, this treatment may not only mitigate symptoms but may also reduce transmissions to susceptible household members who may be at increased risk of complications (eg, because of HIV-1 infection with advanced immunodeficiency) [19].…”

supporting

confidence: 85%

Pandemic Influenza A (H1N1) Outbreak among 15 School‐Aged HIV‐1–Infected Children

et al. 2010

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Patients infected with human immunodeficiency virus type 1 (HIV-1) are considered to be at increased risk for 2009 H1N1 influenza-related complications. We performed an observational study after an outbreak of 2009 H1N1 influenza virus infection among a group of 15 HIV-1-infected school-aged children in Germany in October 2009. Clinical course, kinetics of viral shedding, and antibody response among children with CD4 cell counts >350 cells/μL and 2009 H1N1 influenza virus coinfection did not appear to differ from that among healthy children. Oseltamivir shortened the duration of viral shedding.

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supporting

confidence: 85%

Pandemic Influenza A (H1N1) Outbreak among 15 School‐Aged HIV‐1–Infected Children

et al. 2010

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“…Of 27 HIV‐positive patients with influenza A H1N1 infection seen during the initial months of the Mexico City epidemic, 14 required hospitalization and six died. In addition, there are anecdotal reports of HIV‐infected patients with severe or fatal influenza A H1N1 infection [43,44]. These cases indicate that influenza A H1N1 infection can be severe in already severely ill HIV‐positive patients presenting with concomitant opportunistic infections; in these patients, the missed diagnosis of influenza H1N1 and the subsequent delay in the provision of specific anti‐influenza therapy may be fatal.…”

Section: Discussionmentioning

confidence: 99%

Influenza A H1N1 in HIV-infected adults*

Martínez¹,

Marcos²,

Hoyo-Ulloa³

et al. 2011

HIV Medicine

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Objectives HIV‐infected adults are considered to be at higher risk for influenza A H1N1 complications but data supporting this belief are lacking. We aimed to compare epidemiological data, clinical characteristics, and outcomes of influenza A H1N1 infection between HIV‐infected and ‐uninfected adults. Methods From 26 April to 6 December 2009, each adult presenting with acute respiratory illness at the emergency department of our institution was considered for an influenza A H1N1 diagnosis by specific multiplex real‐time polymerase chain reaction. For every HIV‐infected adult diagnosed, three consecutive adults not known to be HIV‐infected diagnosed in the same calendar week were randomly chosen as controls. Results Among 2106 adults tested, 623 (30%) had influenza A H1N1 infection confirmed. Fifty‐six (9%) were HIV‐positive and were compared with 168 HIV‐negative controls. Relative to HIV‐negative controls, HIV‐positive patients were older, more frequently male, and more frequently smokers (P≤0.02). In the HIV‐positive group, prior or current AIDS‐defining events were reported for 30% of patients, 9% and 30% had CD4 counts of <200 and 200–500 cells/μL, respectively, and 95% had HIV‐1 RNA <50 copies/mL. Pneumonia (9%vs. 25%, respectively, in the HIV‐positive and HIV‐negative groups; P=0.01) and respiratory failure (9%vs. 21%, respectively; P=0.04) were less common in the HIV‐positive group. Oseltamivir (95%vs. 71% in the HIV‐positive and HIV‐negative groups, respectively; P=0.003) was administered more often in HIV‐positive patients. Three patients (all HIV‐negative) died. In the HIV‐positive group, CD4 cell count and plasma HIV‐1 RNA did not differ before and 4–6 weeks after influenza A H1N1 diagnosis (P>0.05). Conclusions HIV infection did not increase the severity of influenza A H1N1 infection, and influenza A H1N1 infection did not have a major effect on HIV infection.

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“…Influenza in immunocompromised individuals is associated with an increased severity of disease [ 54 ] and HIV is recognized as a co-morbidity for 2009 H1N1 influenza [ 54 , 80 ]. The rate of HIV in females are approaching that of males worldwide [ 81 ].…”

Section: H1n1 Overviewmentioning

confidence: 99%

The impact of sex, gender and pregnancy on 2009 H1N1 disease

et al. 2010

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Children and young adults of reproductive age have emerged as groups that are highly vulnerable to the current 2009 H1N1 pandemic. The sex of an individual is a fundamental factor that can influence exposure, susceptibility and immune responses to influenza. Worldwide, the incidence, disease burden, morbidity and mortality rates following exposure to the 2009 H1N1 influenza virus differ between males and females and are often age-dependent. Pregnancy and differences in the presentation of various risk factors contribute to the worse outcome of infection in women. Vaccination and antiviral treatment efficacy also vary in a sex-dependent manner. Finally, sex-specific genetic and hormonal differences may contribute to the severity of influenza and the clearance of viral infection. The contribution of sex and gender to influenza can only be determined by a greater consideration of these factors in clinical and epidemiological studies and increased research into the biological basis underlying these differences.

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Fatal Case of Pneumonia Associated with Pandemic (H1N1) 2009 in HIV-Positive Patient

Cited by 18 publications

References 3 publications

Pandemic Influenza A (H1N1) Outbreak among 15 School‐Aged HIV‐1–Infected Children

Pandemic Influenza A (H1N1) Outbreak among 15 School‐Aged HIV‐1–Infected Children

Influenza A H1N1 in HIV-infected adults*

The impact of sex, gender and pregnancy on 2009 H1N1 disease

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