HIV-infected hospitalized patients with 2009 pandemic influenza A (pH1N1)--United States, spring and summer 2009.

Peters, Philip J; Skarbinski, Jacek; Louie, Janice K; Jain, Seema; New York City Department of Health Swine Flu Investigation Team; Roland, Michelle; Jani, Shilpa G; Finelli, Lyn et al. · Clin Infect Dis · 2011

case_series · Level IV

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Abstract

We describe the clinical findings of HIV-infected patients hospitalized with 2009 pandemic influenza A (pH1N1). Data were derived from 3 separate case series in the United States. Among 911 adults hospitalized with pH1N1 influenza, 31 (3.4%) were HIV infected compared with an HIV prevalence of 0.45% in the general US adult population. HIV-infected influenza patients experienced similar rates of intensive care unit admission (29% vs 34%) and death (13% vs 13%) compared with non-HIV-infected patients. Among HIV-infected patients with available data, 14 (50%) of 28 patients had a CD4 cell count <200 cells/μL, which was not associated with an increased risk of an intensive care unit admission or death. Overall, 25 (81%) HIV-infected patients received influenza antiviral therapy, but treatment was initiated within 48 h of illness onset in only 33% of cases. Clinicians should consider early empiric influenza antiviral treatment in HIV-infected patients presenting with suspected influenza.

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