Journal Article

Invasive Pneumococcal Disease in Patients Infected with HIV: Still a Threat in the Era of Highly Active Antiretroviral Therapy

Queralt Jordano, Vicenç Falcó, Benito Almirante, Ana María Planes, Oscar del Valle, Esteve Ribera, Oscar Len, Carles Pigrau and Albert Pahissa

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 11, pages 1623-1628
Published in print June 2004 | ISSN: 1058-4838
Published online June 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/420933
Invasive Pneumococcal Disease in Patients Infected with HIV: Still a Threat in the Era of Highly Active Antiretroviral Therapy

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We studied all human immunodeficiency virus (HIV)-infected patients with invasive pneumococcal disease who received their diagnosis during 1996–2002 to investigate the incidence of this disease in the highly active antiretroviral therapy era and to study the influence of CD4 lymphocyte count on the clinical presentation and outcome of disease. The overall incidence of invasive pneumococcal disease was 11.3 cases per 100,000 person-years in adult patients without known HIV infection and 677 cases per 100,000 person-years in HIV-infected patients. This incidence remained stable over the study period. Clinical presentation, severity of illness, and number of recurrent episodes were similar in patients with CD4+ cell counts of >200 or ≤200 cells/µL. Patients receiving trimethoprim-sulfamethoxazole (TMP-SMZ) were more likely to present with TMP-SMZ-resistant pneumococci than were those who were not receiving this agent (76.7% vs. 43.6%; P = .007). The mortality rate was high (21%).

Journal Article.  3519 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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