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Recurrent pneumonia mortality risk in a HIV/AIDS Puerto Rican cohort

A M Mayor1, M A Gomez, E Rios

  • 1Retrovirus Research Center, Universidad Central del Caribe, School of Medicine, Bayamón, Puerto Rico, USA. amayorb@hotmail.com

Cellular and Molecular Biology (Noisy-Le-Grand, France)
|February 27, 2004
PubMed

Insights

Recurrent pneumonia in HIV patients indicates a severely compromised immune system. Low CD4+ T cell counts and lack of antiretroviral therapy significantly increase mortality risk in these individuals.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Public Health

Background:

  • Recurrent pneumonia (RP) is a key diagnostic criterion for Acquired Immunodeficiency Syndrome (AIDS).
  • Understanding RP in Human Immunodeficiency Virus (HIV)-infected individuals is crucial for patient management.
  • A cohort study in Puerto Rico examined RP cases in HIV patients between 1992 and 2001.

Purpose of the Study:

  • To investigate the prevalence and characteristics of recurrent pneumonia in a cohort of HIV-infected patients.
  • To identify risk factors associated with mortality following recurrent pneumonia diagnosis in this population.
  • To evaluate the impact of treatment and vaccination on outcomes.

Main Methods:

  • Retrospective analysis of 145 recurrent pneumonia cases from a cohort of 2,996 HIV patients.
  • Data collection included demographics, CD4+ T cell counts, antiretroviral treatment status, vaccination history, and co-existing AIDS-related conditions.
  • Cox proportional hazard analysis was used to determine mortality risk factors.

Main Results:

  • Recurrent pneumonia prevalence was 4.8%, with 77.2% males and 62.1% injecting drug users.
  • At diagnosis, mean CD4+ T cell count was 93.8 cells/mm3; 59.3% received antiretroviral treatment, and only 13% were vaccinated against pneumococcus.
  • The one-year mortality rate was 63.4%, significantly increased by low CD4+ T cells, toxoplasmosis, wasting syndrome, esophageal candidiasis, and fewer antiretroviral medications.

Conclusions:

  • HIV-infected patients with recurrent pneumonia exhibit severely compromised immune systems and low vaccination rates.
  • Low CD4+ T cell counts are a significant predictor of increased hazard and mortality.
  • Antiretroviral therapy is associated with better outcomes and reduced mortality; increased pneumococcal vaccination is recommended to decrease RP incidence.

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