Objective To determine risk factors for and trends in bacterial pneumonia in patients(pts.) with HIV disease. Methods We prospcctively followed 2888 pts. over 4029 person-years (py) from 1989-96. Risk factors for bacterial pneumonia were analyzed by proportional hazards analysis using fixed and time-dependent covariates. Results The annual incidence of bacterial pneumonia ranged from 7.5 to 11.5 cases per 100 py, with no decline in 1996. Drug users had a greater risk (14%) than non-DUs (11%), and blacks were more likely than non-blacks (14% vs. 9%). Pts. with bacterial pneumonia had lower baseline and follow up CD4 cell counts than patients who did not develop disease (p<.0001). In multivariate analysis, risk of bacterial pneumonia was associated with CD4 count (p<.0001), black race (RR 1.2, p=.06 and IDU (RR 2.7, p=.09. TMP-SMX was not protective (RR 1.16, p=.28). When analysis was restricted to pts. with CD4 <200, risk factors included CD4 level and Pneumocystis (RR 2.6), and TMP-SMX again was not protective. Macrolide prophylaxis was associated with a trend towards lower risk (RR 0.27) that was not significant. Conclusion In our heterogeneous clinical cohort, advanced immunodeficiency and a history of PCP are associated with bacterial pneumonia. There has been no decrease in incidence recently, and TMP-SMX is not protective, suggesting increased bacterial resistance. Bacterial pneumonia remains a common complication of HIV disease.
|Original language||English (US)|
|Number of pages||1|
|Journal||Clinical Infectious Diseases|
|State||Published - Dec 1 1997|
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases