Global trends in infectious diseases in HIV-infected patients in HAART era

Abstract number: 1135_242

Guardiola J., Matas L., Lacal A., Herrera S., Mateo M., Mauri A., Corominas H., Puig M., Gurgui M., Benito S., Domingo P.

Background:  

The incidence and prevalence of different microorganisms and infection sites in HIV-infected patients remains controversial. The aim of this study was to evaluate the global presence of infectious diseases during the HAART era.

Methods:  

We retrospectively studied all HIV-AIDS records from 1996 to 2003 at a teaching-urban hospital in Barcelona (Spain). All microbiological positive cultures and infection sites were reviewed from 1996 to 2003. Contamination was ruled out based on clinical grounds. Statistical analysis was performed with standardized methods.

Results:  

We analysed 1502 HIV infected patients. A total of 623 (41%) patients showed one or more infections, with 1681 positive microbiological cultures (371 patients had more than one infection). 429 (68.8%) were men. Mean age was 40 + 9 (range: 18–79). 89% of patients were on highly active antiretroviral therapy. The most frequent isolates were: E. coli 159 (9.5%), M. tuberculosis 132 (7.9%), S. aureus 106 (6.1%), Herpes simplex 84 (5.0%), S. pneumoniae 74 (4.4%), Campylobacter sp 72 (4.3%), Pneumocystis carinii 68 (4.0%), Pseudomonas aeruginosa 59 (3.5%), S. epidermidis 56 (3.3%), Salmonella sp 50 (3.0%). The most frequent clinical syndromes were: Bacteremia 262 (15.5%) cases (S. epidermidis 16%, E. Coli 13%, S. pneumoniae 12%), respiratory infections (whit positive BAL culture) 213 (12.7%) cases (Pneumocystis carinii 32.5%, Candida sp 17.7%, M. tuberculosis 7.2%, S. pneumoniae 5.3%), urinary infections 231 (13.7%) (E. coli 47%, Enterococcus sp 11.4%) and diarrhoea was present in 200 (11.9%) cases (Campylobacter sp 37.9%, Entamoeba 14.9%Cryptosporidium 14.4%, Giardia 13.8%, and Salmonella sp 12.1%).

Conclusions:  

1.  Almost half the patients suffered one infection during the study period.

2.  The most frequent isolated microorganisms were E. coli and M. tuberculosis and S. aureus.

3.  The most frequently involved sites were blood, respiratory, urinary and gastrointestinal tracts.