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Clinical Investigations: HIV |

Legionnaires Disease and HIV Infection*

Maria Luisa Pedro-Botet; Miquel Sabrià; Nieves Sopena; Marian García-Núñez; María Jesús Dominguez; Esteban Reynaga; Celestino Rey-Joly
Author and Funding Information

*From the Infectious Disease Unit (Drs. Pedro-Botet, Sabrià, Sopena, Reynaga, and Ms. García-Núñez) and Department of Internal Medicine (Drs. Dominguez and Rey-Joly), University Hospital “Germans Trias i Pujol,” Universitat Autònoma, Badalona, Spain.

Correspondence to: Maria Luisa Pedro-Botet, MD, PhD, Infectious Diseases Unit, Hospital Universitario Germans Trias i Pujol, Crtra/del Canyet s/n, Badalona 08916, Spain; e-mail: mlpbotet@ns.hugtip.scs.es



Chest. 2003;124(2):543-547. doi:10.1378/chest.124.2.543
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Study objectives: To compare the outcome of Legionnaires disease (LD) in patients with and without HIV infection.

Design: Retrospective review of clinical charts.

Setting: Six hundred-bed university hospital.

Patients: We studied the clinical findings of 64 patients without HIV and 15 patients with HIV. Patients with a serologic diagnosis only were not included. Patients with previous immunosuppressive therapy or transplant recipients were excluded from the former group. In the HIV group, the mean CD4 cell count was 347.5/μL, plasma viral load was undetectable in 50% of the patients, and only one patient (7%) was receiving cotrimoxazole as prophylaxis against Pneumocystis carinii at the time of pneumonia. No differences were observed in the two groups with respect to community or nosocomial acquisition, delay in the initiation of appropriate treatment, the use of macrolides or fluoroquinolones, and Fine score in cases of community-acquired LD.

Results: Univariate analysis showed that time to apyrexia was longer, and respiratory symptoms, bilateral infiltrates in chest radiograph, hyponatremia, increase in aspartate aminotransferase and creatine phosphokinase (CK), and respiratory failure were more frequent in the HIV group. Mortality was greater in patients with HIV, achieving a statistically significant value of 20%; however, multivariate analysis only confirmed these differences with respect to the increase in CK.

Conclusions: LD has a more severe clinical presentation and worse evolution in patients with HIV.


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