[Incidence of pneumonia in HIV-infected patients in the highly active antiretroviral therapy era]. / Incidencia de neumonía en pacientes infectados por el virus de la inmunodeficiencia humana en la era del tratamiento antirretroviral de gran actividad.

BACKGROUND AND OBJECTIVE: There is scant data comparing the incidence of pneumonia in the community and in the human immunodeficiency virus (HIV) population in highly active antiretroviral therapy (HAART) era. PATIENTS AND METHOD: Prospective study during 18 months. Data were obtained by the means of the electronic clinical record. Incidence rate was compared between HIV positive and negative patients. RESULTS: There were 529 pneumonia episodes in global population (n = 220,000), 1.6 cases/1000 person-year. HIV-infected patients (n = 170) suffered 12 episodes of pneumonia; 46 cases/1000 person-year (relative risk = 29.3, 95% confidence interval, 16.34-51.4; p < 0.01). HIV infected patients with pneumonia have a lower CD4 count (mean 434 versus 230 cells/ml; p = 0.04), higher viral load (4.1 versus 3.2 log copies/ml; p = 0.07) and received antiretroviral treatment in a similar proportion compared to HIV without pneumonia (62 versus a 66.7%, p = 0.5). CONCLUSIONS: Pneumonia in HIV infected patients may be about 30 times more frequent than general population in HAART era. Prevention measures should be reinforced.

Incidencia de neumonía en pacientes infectados por el virus de la inmunodeficiencia humana en la era del tratamiento antirretroviral de gran actividad / Incidence of pneumonia in HIV-infected patients in the highly active antiretroviral therapy era

Fundamento y objetivo: Apenas hay datos sobre la incidencia de neumonía en los pacientes infectados por el virus de la inmunodeficiencia humana (VIH) respecto a la población general en la era del tratamiento antirretroviral de gran actividad (TARGA). Pacientes y método: Se ha realizado un registro prospectivo de las neumonías atendidas en un hospital de zona durante 18 meses. Se comparan las tasas de incidencia entre la población general y los pacientes infectados por el VIH. Resultados: En la población general (n = 220.000) la incidencia de neumonía fue de 1,6 casos/1.000 personas/año, frente a 46 casos/ 1.000 personas/año en pacientes infectados por el VIH (n = 170) (riesgo relativo = 29,3; intervalo de confianza del 95%, 16,34-51,4; p < 0,01). Los pacientes seropositivos con neumonía tenían una cifra inferior de linfocitos CD4 (media de 434 frente a 230 células/ml; p = 0,04), una carga viral más elevada (4,1 frente a 3,2 log copias/ml; p = 0,07) y recibían TARGA en un porcentaje similar a los que no presentaron neumonía (el 62 frente al 66,7%; p = 0,5). Conclusiones: En la era del TARGA, la incidencia de neumonía en la población infectada por el VIH puede ser unas 30 veces superior a la de la población general, por lo que es necesario reforzar las medidas de prevención en este tipo de pacientes

Background and objective: There is scant data comparing the incidence of pneumonia in the community and in the human immunodeficiency virus (HIV) population in highly active antiretroviral therapy (HAART) era. Patients and method: Prospective study during 18 months. Data were obtained by the means of the electronic clinical record. Incidence rate was compared between HIV positive and negative patients. Results: There were 529 pneumonia episodes in global population (n = 220,000), 1.6 cases/1000 person-year. HIV-infected patients (n = 170) suffered 12 episodes of pneumonia; 46 cases/1000 person-year (relative risk = 29.3, 95% confidence interval, 16.34-51.4; p < 0.01). HIV infected patients with pneumonia have a lower CD4 count (mean 434 versus 230 cells/ml; p = 0.04), higher viral load (4.1 versus 3.2 log copies/ml; p = 0.07) and received antiretroviral treatment in a similar proportion compared to HIV without pneumonia (62 versus a 66.7%, p = 0.5). Conclusions: Pneumonia in HIV infected patients may be about 30 times more frequent than general population in HAART era. Prevention measures should be reinforced