Legionnaires disease and HIV infection.

Abstract:

STUDY OBJECTIVES:To compare the outcome of Legionnaires disease (LD) in patients with and without HIV infection. DESIGN:Retrospective review of clinical charts. SETTING:Six hundred-bed university hospital. PATIENTS:We studied the clinical findings of 64 patients without HIV and 15 patients with HIV. Patients with a serologic diagnosis only were not included. Patients with previous immunosuppressive therapy or transplant recipients were excluded from the former group. In the HIV group, the mean CD4 cell count was 347.5/ microL, plasma viral load was undetectable in 50% of the patients, and only one patient (7%) was receiving cotrimoxazole as prophylaxis against Pneumocystis carinii at the time of pneumonia. No differences were observed in the two groups with respect to community or nosocomial acquisition, delay in the initiation of appropriate treatment, the use of macrolides or fluoroquinolones, and Fine score in cases of community-acquired LD. RESULTS:Univariate analysis showed that time to apyrexia was longer, and respiratory symptoms, bilateral infiltrates in chest radiograph, hyponatremia, increase in aspartate aminotransferase and creatine phosphokinase (CK), and respiratory failure were more frequent in the HIV group. Mortality was greater in patients with HIV, achieving a statistically significant value of 20%; however, multivariate analysis only confirmed these differences with respect to the increase in CK. CONCLUSIONS:LD has a more severe clinical presentation and worse evolution in patients with HIV.

journal_name

Chest

journal_title

Chest

authors

Pedro-Botet ML,Sabrià M,Sopena N,García-Núñez M,Dominguez MJ,Reynaga E,Rey-Joly C

doi

10.1378/chest.124.2.543

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

543-7

issue

2

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)33336-5

journal_volume

124

pub_type

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