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| Autor | Mamani, Roxana Flores | |
| Autor | López, Tiago de Assunção | |
| Autor | Jalo, Waldir Madany | |
| Autor | Alves, Marcelo Ribeiro | |
| Autor | Nunes, Estevão Portela | |
| Autor | Pereira, Mario Sérgio | |
| Autor | Silva, Erica Aparecida dos Santos Ribeiro da | |
| Autor | Lourenço, Maria Cristina da Silva | |
| Autor | Veloso, Valdiléa G. | |
| Autor | Grinsztejn, Beatriz | |
| Autor | Cardoso, Sandra Wagner | |
| Autor | Lamas, Cristiane da Cruz | |
| Fecha de acceso | 2023-09-27T21:27:51Z | |
| Fecha de disponibilización | 2023-09-27T21:27:51Z | |
| Fecha de publicación | 2023 | |
| Referencia | MAMANI, Roxana Flores et al. Invasive Pneumococcal Disease in People Living with HIV: A Retrospective Case—Control Study in Brazil. Tropical Medicine and Infectious Disease, v. 19, n. 8, p. 1-14, Jun. 2023. | en_US |
| ISSN | 2414-6366 | |
| URI | https://www.arca.fiocruz.br/handle/icict/60575 | |
| Idioma | eng | en_US |
| Editor | MDPI | en_US |
| Derechos de autor | open access | en_US |
| Título | Invasive Pneumococcal Disease in People Living with HIV: A Retrospective Case-Control Study in Brazil | en_US |
| Tipo del documento | Article | en_US |
| DOI | 10.3390/tropicalmed8060328 | |
| Resumen en Inglés | HIV-infected patients are at particular risk for invasive pneumococcal disease (IPD). We describe cases of IPD in people living with HIV/AIDS (PLWHA) and find associated risk factors for infection and death. Methods: A retrospective case-control study, nested in a cohort, including PLWHA with and without IPD, conducted in Brazil, 2005–2020. Controls were of the same gender/age and seen at the same time/place as cases. Results: We identified 55 episodes of IPD (cases) in 45 patients and 108 controls. The incidence of IPD was 964/100,000 person-years. A total of 42 of 55 (76.4%) IPD episodes presented with pneumonia and 11 (20%) with bacteremia without a focus and 38/45 (84.4%) were hospitalized. Blood cultures were positive in 54/55 (98.2%). Liver cirrhosis and COPD were the only factors associated with IPD in PLWHA in univariate analysis, although no associated factors were found in multivariate analysis. Penicillin resistance was found in 4/45 (8.9%). Regarding antiretroviral therapy (ART), 40/45 (88.9%) cases vs. 80/102 controls (74.1%) were in use (p = 0.07). Patients with HIV and IPD had a higher CD4 count of 267 cells/mm3 compared with the control group, in which it was 140 cells/mm3 (p = 0.027). Pneumococcal vaccination was documented in 19%. Alcoholism (p = 0.018), hepatic cirrhosis (p = 0.003), and lower nadir CD4 count (p = 0.033) were associated with the risk of death in patients with IPD. In-hospital mortality among PLWHA and IPD was 21.1%, and it was associated with thrombocytopenia and hypoalbuminemia, elevated band forms, creatinine, and aspartate aminotransferase (AST). Conclusions: The incidence of IPD in PLWHA remained high despite ART. The vaccination rate was low. Liver cirrhosis was associated with IPD and death. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Universidade do Grande Rio/Afya. Campus Departamento de Medicina. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | en_US |
| Afiliación | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil / Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brasil. | en_US |
| Palavras clave en Inglês | HIV/AIDS | en_US |
| Palavras clave en Inglês | Streptococcus pneumoniae | en_US |
| Palavras clave en Inglês | Pneumococcus | en_US |
| Palavras clave en Inglês | Invasive pneumococcal disease | en_US |
| Palavras clave en Inglês | Vaccination | en_US |
| Palavras clave en Inglês | Brazil | en_US |
| e-ISSN | 2414-6366 | |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar |
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