Adult Patients Living With Human Immunodeficiency Virus Hospitalized for Community-Acquired Pneumonia in the United States: Incidence and Outcomes

Background: Community-acquired pneumonia (CAP) is a common infectious reason for hospitalization of adults in the United States (US), including those with Human Immunodeficiency Virus (HIV). While there are studies detailing the incidence and outcomes for all adults with CAP we are not aware of a recent study detailing incidence and outcomes in adult HIV patients hospitalized with CAP. The objectives of this study were (1) to define the current incidence and outcomes of adult HIV patients hospitalized with CAP in Louisville, Kentucky, and (2) to estimate the burden of CAP in the US HIV adult population. Methods: This was a secondary analysis of The University of Louisville Pneumonia Study; a prospective population-based cohort study of all hospitalized adults with CAP who were residents of Louisville, Kentucky, from 1 June 2014 to 31 May 2016. Results: A total of 110 unique patients living with HIV were hospitalized with CAP during our two-year study. The annual incidence of adults living with HIV hospitalized with CAP is estimated to be 1,950 per 100,000. Of the estimated 1.1 million adults living with HIV in the US currently we predict that 21,450 will be hospitalized with CAP annually. The median time to clinical stability in adult patients living with HIV hospitalized with CAP was 2 (IQR: [1, 3]) days. The median length of stay for adult patients living with HIV hospitalized with CAP was 4 (IQR: [3, 7]) days. Mortality occurred as follows; in-hospital: 1.8%, 30-day 6.8%, 6-month 15.5%, and 1 year 20.2%. Conclusion: The estimated annual incidence of adult patients living with HIV and hospitalized with CAP was found to be 1,950 per 100,000 suggesting that 21,450 adults living with HIV will be admitted with CAP yearly across the US. This is a similar incidence to that recently predicted for the elderly. Mortality occurred as follows; in-hospital: 1.8%, 30-day 6.8%, 6-month 15.5%, and 1 year 20.2%. Our 30-day mortality rate for adult patients living with HIV hospitalized for CAP was similar to other figures in the literature. DOI: 10.18297/jri/vol2/iss1/4 Received Date: February 12, 2018 Accepted Date: March 16, 2018 Website: https://ir.library.louisville.edu/jri Affiliations: 1University of Louisville Division of Infectious Diseases, Louisville, KY 40202 ©2018, The Author(s). 17 ULJRI Vol 2, (1) 2018 ORIGINAL RESEARCH *Correspondence To: Leslie Beavin, MD Assistant Professor of Medicine Division of Infectious Diseases, University of Louisville Work Address: 501 E Broadway, Suite 120 Louisville, KY 40202 Work Email: labeav03@louisville.edu number (SSN), or who were in the correctional system were not included. Data was collected on participants from the medical record including; age, sex, race, body mass index (BMI), HIV status, presence of malignancy, presence of renal disease, presence of heart disease, presence of chronic obstructive pulmonary disease (COPD), history of cerebrovascular event (CVA), smoking status, presence of diabetes, temperature, respiratory rate, blood pressure, heart rate, serum bicarbonate, blood urea nitrogen, serum glucose, serum hematocrit, serum sodium, admission location, presence of altered mental status (AMS), vasopressor requirements, ventilator requirements, and PSI score.