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
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)
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: email@example.com)
† These authors contributed equally to this work.