Pneumococcus-Still an Opportunist for People Living With Human Immunodeficiency Virus-Now What?
| Autor: | Elizabeth R. Jenny-Avital |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Microbiology (medical)
community-acquired pneumonia business.industry Incidence Human immunodeficiency virus (HIV) HIV HIV Infections Pneumonia medicine.disease_cause pneumococcal disease vaccination Virology Pneumococcal Infections Infectious Diseases Streptococcus pneumoniae AcademicSubjects/MED00290 Risk Factors medicine Humans epidemiology business Articles and Commentaries |
| Zdroj: | Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America |
| ISSN: | 1537-6591 |
| Popis: | Background Although people living with human immunodeficiency virus (PLWH) are at increased risk of invasive pneumococcal disease (IPD) and community-acquired pneumonia (CAP), it is unclear whether this remains the case in the setting of early initiation of combination antiretroviral therapy (cART), at high CD4 cell counts. This is important, as pneumococcal vaccination coverage in PLWH is low in Europe and the United States, despite longstanding international recommendations. Methods We identified all CAP and IPD cases between 2008 and 2017 in a cohort of PLWH in a Dutch HIV referral center. We calculated incidence rates stratified by CD4 count and cART status and conducted a case-control study to identify risk factors for CAP in PLWH receiving cART. Results Incidence rates of IPD and CAP in PLWH were 111 and 1529 per 100 000 patient-years of follow-up (PYFU). Although IPD and CAP occurred more frequently in patients with CD4 counts 500 cells/μL remained higher compared with the general population (946 vs 188 per 100 000 PYFU). All IPD isolates were vaccine serotypes. Risk factors for CAP were older age, CD4 counts The incidence of pneumococcal disease and pneumonia among people living with HIV (PLWH) remains higher compared with the general population, even in those who are virally suppressed, and have high CD4 cell counts. Pneumococcal vaccination should be considered in all PLWH. |
| Databáze: | OpenAIRE |
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