Epidemiology and Infection
- Epidemiology and Infection / Volume 139 / Issue 09 / September 2011, pp 1317-1325
- Copyright © Cambridge University Press 2010 The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <http://creativecommons.org/licenses/by-nc-sa/2.5/>. The written permission of Cambridge University Press must be obtained for commercial re-use.
- DOI: http://dx.doi.org/10.1017/S0950268810002669 (About DOI), Published online: 26 November 2010
- OPEN ACCESS
Community-acquired pneumonia and bacteraemia
Pneumonia and influenza hospitalization in HIV-positive seniors
S. M. MORa1 c1†, J. A. AMINAWUNGa1†, A. DEMARIA Jr.a2 and E. N. NAUMOVAa1
a1 Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
a2 Bureau of Infectious Disease Prevention, Response and Services, Massachusetts Department of Public Health, Boston, MA, USA
SUMMARY
HIV-positive persons and the elderly have increased risk for influenza-related complications, including pneumonia. Using claims data for pneumonia and influenza (P&I) hospitalization in the USA, we described the temporo-demographic trends and in-patient case-fatality in persons aged ≥65 years by HIV status. Our results showed a near doubling in the fraction of P&I admissions representing HIV-positive persons between 1991 and 2004 [relative risk (RR) 1·95, 95% confidence interval (CI) 1·80–2·13]. HIV-positive adults were younger (70·3 vs. 79·9 years, P<0·001), and had higher case-fatality (18·0% vs. 12·6%, P<0·001). Adjusting for other variables, case-fatality decreased by 5·8% in HIV-positive persons with the availability of highly active antiretroviral therapy (P=0·032). However, HIV-positive seniors were still 51% more likely to die during hospitalization than HIV-negative persons in 2004 (OR 1·51, 95% CI 1·23–1·85). HIV-infected persons represent a growing fraction of the elderly population hospitalized with P&I. Additional measures are needed to reduce case-fatality associated with P&I in this population.
(Accepted October 27 2010)
(Online publication November 26 2010)
Correspondence:
c1 Author for correspondence: Dr S. M. Mor, Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Avenue, Boston MA 02111, USA. (Email: siobhan.mor@tufts.edu)
Footnotes
† These authors contributed equally to this work.
