SAN FRANCISCO — Patients with HIV do just as well as patients without the virus when faced with bacterial community-acquired pneumonia, according to a poster presentation by Dr. Maricar Malinis at the International Conference of the American Thoracic Society.
Dr. Malinis, of the University of Louisville (Ky.), and colleagues concluded that “the decision to hospitalize a patient [with community-acquired pneumonia] should not be based on the HIV status, but rather on the severity of illness.”
The investigators conducted a large, retrospective study based on a database maintained by the Community-Acquired Pneumonia Organization (CAPO).
The CAPO database is the result of an international cohort study of patients with community-acquired pneumonia (CAP) hospitalized between 2001 and 2006.
Dr. Malinis and associates included in their analysis a total of 2,908 patients, of whom 118 (4.1%) were HIV positive.
There were no significant differences between the groups in all-cause mortality or CAP-related mortality, measured at hospital discharge.
In the unadjusted results, there were significant differences between the groups in the time to reach clinical stability and length of hospital stay.
In both measures, patients with HIV did better than patients without HIV.
But the statistical differences disappeared when the results were adjusted for significant demographic and clinical covariates.
For example, patients who had HIV were significantly younger on average than patients without the virus (40 years vs. 67 years). Also, more of the HIV-positive patients were men (74% vs. 61%) and fewer of them had a cavitary lesion (9% vs. 20%).
The investigators wrote that the results of the study suggest that, at least in the area of hospitalization, the current national guidelines for managing patients with CAP can be applied to patients who have HIV.