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Risk of Severe Bacterial Infection in People Living Human Immunodeficiency Virus Infection in the Combined Antiretroviral Therapy Era
- Source :
- Journal of Infectious Diseases, Journal of Infectious Diseases, 2020, 222 (5), pp.765-776. ⟨10.1093/infdis/jiaa154⟩, Journal of Infectious Diseases, Oxford University Press (OUP), 2020, 222 (5), pp.765-776. ⟨10.1093/infdis/jiaa154⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- BackgroundSevere bacterial infections are the first cause of morbidity in people with human immunodeficiency virus (PWH). We aimed to assess their incidence and to analyze their determinants.MethodsWe studied human immunodeficiency virus (HIV)-1-infected individuals aged at least 15 years and prospectively followed between 2006 and 2015 in the French Hospital Database on HIV. The Andersen and Gill model was used to calculate the adjusted hazard ratios (HRs), focusing on heavy alcohol use and neutrophil function-altering comorbidities.ResultsOf 25 795 participants, 1414 developed 1883 severe bacterial infections. Between 2006 and 2009 and 2013 and 2015, the incidence fell from 13.2 (95% confidence interval [CI], 12.3–14.1) to 7.1 (95% CI, 6.3–7.8) per 1000 person-years. Heavy alcohol use was associated with an increased risk of severe bacterial infection (HR = 1.3, 95% CI = 1.1–1.7 for 40–80 g/day and HR = 1.6, 95% CI = 1.2–2.1 for >80 g/day), as were diabetes, chronic kidney disease, and end-stage liver disease (HR = 1.2, 95% CI = 1.0–1.4 when 1 comorbidity; HR = 2.3, 95% CI = 1.6–3.4 when more than 1 comorbidity), and nonacquired immune deficiency syndrome-defining malignancy (HR = 2.0; 95% CI, 1.6–2.4).ConclusionsHeavy alcohol use was associated with an increased risk of severe bacterial infection, as were neutrophil function-altering comorbidities. Controlled-drinking approaches should be promoted and comorbidity management should be strengthened in PWH.
- Subjects :
- Male
0301 basic medicine
Databases, Factual
Neutrophils
[SDV]Life Sciences [q-bio]
HIV Infections
Comorbidity
Leukocyte Count
Liver disease
0302 clinical medicine
Risk Factors
Immunology and Allergy
Prospective Studies
030212 general & internal medicine
diabetes
Incidence
Incidence (epidemiology)
Hazard ratio
Bacterial Infections
Middle Aged
3. Good health
[SDV] Life Sciences [q-bio]
Alcoholism
Infectious Diseases
Anti-Retroviral Agents
Drug Therapy, Combination
Female
France
liver disease
Adult
medicine.medical_specialty
Neutropenia
Malignancy
Risk Assessment
AIDS-defining malignancy
End Stage Liver Disease
03 medical and health sciences
Internal medicine
Diabetes mellitus
Diabetes Mellitus
medicine
Humans
Renal Insufficiency, Chronic
Aged
business.industry
HIV
medicine.disease
Confidence interval
030104 developmental biology
HIV-1
business
chronic kidney disease
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 00221899 and 15376613
- Database :
- OpenAIRE
- Journal :
- Journal of Infectious Diseases, Journal of Infectious Diseases, 2020, 222 (5), pp.765-776. ⟨10.1093/infdis/jiaa154⟩, Journal of Infectious Diseases, Oxford University Press (OUP), 2020, 222 (5), pp.765-776. ⟨10.1093/infdis/jiaa154⟩
- Accession number :
- edsair.doi.dedup.....4fca9f02cbf992fee5287cb8430b4898