Influence of human immunodeficiency virus 1 infection and degree of immunosuppression in the clinical characteristics and outcome of infective endocarditis in intravenous drug users.
Immunosuppression caused by human immunodeficiency virus 1 (HIV) infection appears to modify the clinical characteristics and to increase the severity of several bacterial infections.
The impact of HIV infection and the degree of immunosuppression on the clinical characteristics and outcome of infective endocarditis (IE) in intravenous (IV) drug users has not been well characterized.
Prospective cohort study among 292 consecutive IV drug users with IE diagnosed in 2 academic institutional hospitals in Barcelona, Spain, from January 1,1984, to October 31,1995.
Serostatus of HIV infection was documented in 283 patients.
We measured demographics, clinical and biological data, cause, echocardiographic findings, HIV serostatus and classification, CD4 cell count, complications, and mortality.
Among the 283 episodes ofIE, 216 (76.3%) were in HIV-infected patients and 67 (23.7%) in non-HIV-infected patients.
Rate of IE per 1000 admissions ranged from 0.17 to 0.82 per year, peaking in 1989.
Characteristics of IE independently associated with HIV infection were right-side involvement (odds ratio [OR], 7.6 ; 95% confidence interval [CI], 3.5-16.7), a micro-organism different from viridans streptococci (OR, 2.5 ; 95% Cl, 1.1-5.9), duration of drug abuse longer than 5 years (OR, 5.0 ; 95% Cl, 2.4-10.3), and white blood cell count of no more than 10 x 109/L (OR, 2.2 ; 95% Cl, 1.1-4.2). (...)
Mots-clés Pascal : SIDA, Virose, Infection, Virus immunodéficience humaine, Lentivirus, Retroviridae, Virus, Complication, Endocardite, Association, Voie intraveineuse, Toxicomanie, Exploration clinique, Facteur risque, Immunodépression, Etude cohorte, Homme, Espagne, Europe, Immunopathologie, Immunodéficit, Appareil circulatoire pathologie, Cardiopathie, Endocarde pathologie, Bactériose, Toxicologie
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Human immunodeficiency virus, Lentivirus, Retroviridae, Virus, Complication, Endocarditis, Association, Intravenous administration, Drug addiction, Clinical investigation, Risk factor, Immunosuppression, Cohort study, Human, Spain, Europe, Immunopathology, Immune deficiency, Cardiovascular disease, Heart disease, Endocardial disease, Bacteriosis, Toxicology
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0490732
Code Inist : 002B05C02D. Création : 19/02/1999.