The impact of potent antiretroviral therapy on the characteristics of hospitalized patients with HIV infection

Paul, Simon; Gilbert, Holly M.; Ziecheck, Wendy; Jacobs, Jonathan L.; Sepkowitz, Kent A.

doi:10.1097/00002030-199902250-00015

Cited by 113 publications

(51 citation statements)

References 7 publications

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“…During this period, PAUL et al [132] observed a two-fold decrease in the incidence of hospital admissions for HIV-infected patients but, in 1997, bacterial pneumonia remained the most common diagnosis at admission.…”

Section: Human Immunodeficiency Virus-infected Patients Receiving Higmentioning

confidence: 99%

Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients

Mayaud

Parrot²,

Cadranel³

2002

Eur Respir J

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In human immunodeficiency virus (HIV)-infected patients, bacterial lower respiratory tract infections are the most frequent respiratory diseases. They are frequently the first clinical manifestation of HIV infection.The incidence and severity of bacterial lower respiratory tract infections increase with the degree of immunosuppression. At the acquired immune deficiency syndrome (AIDS) stage, the responsible bacteria and clinical presentation may be atypical. Bacterial pneumonia may be fatal, particularly in AIDS patients, and its occurrence is predictive of a reduced survival time.Pneumococcal vaccine is recommended in patients with a CD4 T‐lymphocyte count of >200 cells·mm−3and cotrimoxazole (trimethoprim/sulfamethoxazole) in patients with a CD4 T‐lymphocyte count of <200 cells·mm−3. Unfortunately, such prophylaxis remains insufficiently prescribed and its protective effect is limited.Highly active antiretroviral treatment has dramatically reduced the incidence of lower respiratory tract infection due toPseudomonasaeruginosaand opportunistic bacteria. In contrast, successful highly active antiretroviral therapy slightly decreased the risk of bacterial pneumonia due to usual bacteria, even in patients on successful highly active antiretroviral therapy.

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Section: Human Immunodeficiency Virus-infected Patients Receiving Higmentioning

confidence: 99%

Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients

Mayaud

Parrot²,

Cadranel³

2002

Eur Respir J

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“…[1][2][3][4] HIVinfected patients remain a "fragile" population, even after achieving an acceptable immunological status, as their mortality decreases to levels comparable to the general population only after 6-10 y of immune-recovery and HIV-RNA suppression. 5,6 Many factors appear to predispose HIVinfected patients to invasive bacterial and fungal infections; in particular, altered cell-mediated immunity, B-cell dysfunction with consequent lack of serum opsonins as well as qualitative and quantitative deficits of neutrophils.…”

Section: Introductionmentioning

confidence: 99%

Bloodstream infections in HIV-infected patients

2016

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In the combined antiretroviral therapy era, HIV-infected patients remain a vulnerable population for the onset of bloodstream infections (BSI). Worldwide, nontyphoid salmonellae, Streptococcus pneumoniae, Escherichia coli, Staphylococcus aureus and coagulase negative staphylococci are the most important pathogens. Intravenous catheter associated infection, skin-soft tissue infection and endocarditis are associated with Gram-positive bacteremia. Among the Gram-negative, nontyphoidal Salmonella have been previously correlated to sepsis. Other causes of BSI in HIVinfected patients are mycobacteria and fungi. Mycobacteria constitute a major cause of BSI in limited resource countries. Fungal BSI are not frequent and among them Cryptococcus neoformans is the most common life-threatening infection. The degree of immunosuppression remains the key prognostic factor leading to the development of BSI.

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“…The main diagnostic groups are bacterial pneumonia (BP), Pneumocystis carinii pneumonia (PCP), and mycobacteriosis, in that order. BP is currently the most common admission diagnosis in this population (2,26). Pulmonary infections usually appear as pulmonary infiltrates (PIs) on chest radiographs and are frequently (but not always) associated with respiratory symptoms.…”

mentioning

confidence: 99%

Inflammatory Responses in Blood Samples of Human Immunodeficiency Virus-Infected Patients with Pulmonary Infections

Benito

Moreno

Filella³

et al. 2004

Clin Vaccine Immunol

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We analyzed the characteristics of the inflammatory response occurring in blood during pulmonary infections in human immunodeficiency virus (HIV)-infected patients. A prospective study of consecutive hospital admissions of HIV-infected patients with new-onset radiologic pulmonary infiltrates was carried out in a tertiary university hospital from April 1998 to May 2001. Plasma cyclic AMP receptor protein (CRP), interleukin 1␤ (IL-1␤), IL-6, IL-8, IL-10, and tumor necrosis factor alpha (TNF-␣) levels were determined at the time of admission and 4, 5, and 6 days later. Patients were included in a protocol addressed to study etiology and outcome of disease. A total of 249 episodes of infection were included, with the main diagnoses being bacterial pneumonia (BP) (118 episodes), Pneumocystis carinii pneumonia (PCP) (41 episodes), and mycobacteriosis (36 episodes). For these three patient groups, at the time of admission the median CRP and cytokine levels were as follows: CRP, 10.2, 3.8 and 5 mg/dl, respectively (P ‫؍‬ 0.0001); IL-8, 19, 3, and 2.9 pg/ml (P ‫؍‬ 0.045); and TNF-␣, 46.4, 44, and 75 pg/ml, respectively (P ‫؍‬ 0.029). There were no significant differences in levels of IL-1␤, IL-6, or IL-10 among the patient groups. A total of 23 patients died. At the time of admission, HIV-infected patients with BP had higher plasma CRP and IL-8 levels than did PCP and mycobacteriosis patients. TNF-␣ levels were higher in patients with mycobacteriosis. An elevated IL-8 level (>61 pg/ml) at the time of admission was an independent factor associated with higher mortality (odds ratio, 12; 95% confidence interval, 1.2 to 235.5).

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The impact of potent antiretroviral therapy on the characteristics of hospitalized patients with HIV infection

Cited by 113 publications

References 7 publications

Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients

Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients

Bloodstream infections in HIV-infected patients

Inflammatory Responses in Blood Samples of Human Immunodeficiency Virus-Infected Patients with Pulmonary Infections

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