دورية أكاديمية
Invasive Pneumococcal Disease in People Living with HIV: A Retrospective Case-Control Study in Brazil.
| العنوان: | Invasive Pneumococcal Disease in People Living with HIV: A Retrospective Case-Control Study in Brazil. |
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| المؤلفون: | Mamani RF; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., López TA; Barra da Tijuca Campus, Department of Medicine, Universidade do Grande Rio/Afya, Avenida Ayrton Senna, 2.200, Barra da Tijuca 22775-003, RJ, Brazil., Jalo WM; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Alves MR; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Nunes EP; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Pereira MS; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Silva EADSRD; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Lourenço MCDS; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Veloso VG; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Grinsztejn BJ; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Cardoso SW; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil., Lamas CDC; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Avenida Brasil 4365-Manguinhos, Rio de Janeiro 21040-360, RJ, Brazil.; Instituto Nacional de Cardiologia, Rua das Laranjeiras, 374-Laranjeiras, Rio de Janeiro 22240-006, RJ, Brazil. |
| المصدر: | Tropical medicine and infectious disease [Trop Med Infect Dis] 2023 Jun 19; Vol. 8 (6). Date of Electronic Publication: 2023 Jun 19. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101709042 Publication Model: Electronic Cited Medium: Internet ISSN: 2414-6366 (Electronic) Linking ISSN: 24146366 NLM ISO Abbreviation: Trop Med Infect Dis Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Basel, Switzerland : MDPI AG, [2016]- |
| مستخلص: | HIV-infected patients are at particular risk for invasive pneumococcal disease (IPD). We describe cases of IPD in people living with HIV/AIDS (PLWHA) and find associated risk factors for infection and death. Methods: A retrospective case-control study, nested in a cohort, including PLWHA with and without IPD, conducted in Brazil, 2005-2020. Controls were of the same gender/age and seen at the same time/place as cases. Results: We identified 55 episodes of IPD (cases) in 45 patients and 108 controls. The incidence of IPD was 964/100,000 person-years. A total of 42 of 55 (76.4%) IPD episodes presented with pneumonia and 11 (20%) with bacteremia without a focus and 38/45 (84.4%) were hospitalized. Blood cultures were positive in 54/55 (98.2%). Liver cirrhosis and COPD were the only factors associated with IPD in PLWHA in univariate analysis, although no associated factors were found in multivariate analysis. Penicillin resistance was found in 4/45 (8.9%). Regarding antiretroviral therapy (ART), 40/45 (88.9%) cases vs. 80/102 controls (74.1%) were in use ( p = 0.07). Patients with HIV and IPD had a higher CD4 count of 267 cells/mm 3 compared with the control group, in which it was 140 cells/mm 3 ( p = 0.027). Pneumococcal vaccination was documented in 19%. Alcoholism ( p = 0.018), hepatic cirrhosis ( p = 0.003), and lower nadir CD4 count ( p = 0.033) were associated with the risk of death in patients with IPD. In-hospital mortality among PLWHA and IPD was 21.1%, and it was associated with thrombocytopenia and hypoalbuminemia, elevated band forms, creatinine, and aspartate aminotransferase (AST). Conclusions: The incidence of IPD in PLWHA remained high despite ART. The vaccination rate was low. Liver cirrhosis was associated with IPD and death. |
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| فهرسة مساهمة: | Keywords: Brazil; HIV/AIDS; Streptococcus pneumoniae; invasive pneumococcal disease; pneumococcus; vaccination |
| تواريخ الأحداث: | Date Created: 20230627 Latest Revision: 20230701 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10304155 |
| DOI: | 10.3390/tropicalmed8060328 |
| PMID: | 37368746 |
| قاعدة البيانات: | MEDLINE |
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