Clinical outcomes of HIV-infected patients hospitalized with bacterial community-acquired pneumonia
Received 4 November 2008; received in revised form 10 February 2009; accepted 1 March 2009. published online 08 July 2009.
Summary
Background
There are limited and conflicting data on clinical outcomes of community-acquired pneumonia (CAP) among HIV-infected patients.
Methods
Secondary analyses of clinical outcomes of CAP were performed for 118 patients with HIV infection and 2790 patients without HIV infection enrolled in the Community-Acquired Pneumonia Organization (CAPO) international study. After adjustment for significant confounders, the effect of HIV infection on length of stay (LOS) and time to clinical stability (TCS) were examined by survival analyses and overall mortality and CAP-related mortality by logistic regression methods.
Results
After adjusting for significant confounders, hospitalized HIV-infected patients with CAP did not have longer times to reach clinical stability (HR 1.126; 95% CI 0.917–1.391; p=0.251) or longer stays in the hospital (HR 1.191, 95% CI 0.979–1.449; p=0.080). In addition, HIV infection did not significantly influence overall mortality rates (OR 1.205, 95% CI 0.686–2.116; p=0.517) or CAP-related mortality rates (OR 1.338; 95% CI 0.623–3.725; p=0.355).
Conclusion
The presence of HIV infection did not influence the clinical outcomes of CAP among patients assessed at CAPO centers. It is not intended that our results be extrapolated to populations receiving limited healthcare for advanced HIV disease, malnourishment and parasitic diseases.
Corresponding Editor: Mark Holodniy, California, USA