Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study
The impact of HIV infection on the evolution of acute community-acquired pneumonia (CAP) is still controversial. The aim of this study was to investigate possible differences in the clinical presentation and in-hospital outcomes of patients with CAP with and without HIV infection in a specialised service in Yaounde.
Medical files of 106 patients (51 men) aged 15 years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied.
Sixty-two (58.5%) patients were HIV infected. The median age of all patients was 40 years (interquartile range: 31.75-53) and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range) was 14,600/mm3 (10,900-20,600) and 10,450/mm3 (6,400-16,850) respectively in HIV negative and HIV positive patients (p = 0.002). Median haemoglobin level (interquartile range) was 10.8 g/dl (8.9-12) in HIV negative and 9.7 g/dl (8–11.6) in HIV positive patients (p = 0.025). In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p = 0.137) and mortality rates (9% vs. 14.5%, p = 0.401) were similar between HIV negative and HIV positive patients.
Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.
- Koulla-Shiro, S, Kuaban, C, Belec, L (1996) Acute community-acquired bacterial pneumonia in Human Immunodeficiency Virus (HIV) infected and non-HIV-infected adult patients in Cameroon: aetiology and outcome. Tuber Lung Dis 77: pp. 47-51 CrossRef
- Horo, K, Koffi, N, Kouassi, B, N’gom, AS, Kenmogné, K, Ahui, BJM (2004) Facteurs de décès par pneumopathie aiguë communautaire en milieu africain à Abidjan. Rev Pneumol Trop 1: pp. 10-13
- Horo, K, Gode, VC, Ahui, JM, Kouassi, AB, Djereke, GB, Cardenat, M, N'gom, A, Koffi, N, Aka-Danguy, E (2009) Pneumonies communautaires d’allure bactérienne chez le sujet infecté par le VIH : étude préliminaire prospective. Rev Pneumol Clin 65: pp. 137-142 CrossRef
- Benito, N, Moreno, A, Miro, MJ, Torres, A (2011) Pulmonary infections in HIV-infected patients: an update in the 21st century. ERJ Express.
- Cordero, E, Pachón, J, Rivero, A, Girón, JA, Gómez-Mateos, J, Merino, MD, Torres-Tortosa, M, González-Serrano, M, Aliaga, L, Collado, A, Hernández-Quero, J, Barrera, A, Nuño, E (2000) Community-acquired bacterial pneumonia in Enfermedades Infecciosas. Am J Respir Crit Care Med 162: pp. 2063-2068
- Christensen, D, Feldman, C, Rossi, P, Marrie, T, Blasi, F, Luna, C, Fernandez, P, Porras, J, Martinez, J, Weiss, K, Levy, G, Lode, H, Gross, P, File, T, Ramirez, J (2005) Community-Acquired Pneumonia Organization Investigators. HIV infection does not influence clinical outcomes in hospitalized patients with bacterial community-acquired pneumonia: results from the CAPO international cohort study. Clin Infect Dis 15: pp. 554-556 CrossRef
- Malinis, M, Myers, J, Bordon, J, Peyrani, P, Kapoor, R, Nakamatzu, R, Lopardo, G, Torres, A, Feldman, C, Allen, M, Arnold, F, Ramirez, J (2010) Clinical outcomes of HIV-infected patients hospitalized with bacterial community-acquired pneumonia. Int J Infect Dis 14: pp. e22-27 CrossRef
- Koffi, N, N’gom, A, Kouassi, B, Aka-Danguy, E, Tchamran, MM (1997) Les pneumopathies bactériennes à germes banals au cours de l’infection par le VIH chez l’adulte africain hospitalisé à Abidjan. Cote d’Ivoire Bull Soc Path Ex 90: pp. 370-372
- Van der Eerden, MM, Vlaspolder, F, De Graaff, CS, Groot, T, Bronsveld, W, Jansen, HM, Boersma, WG (2005) Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study. Thorax 60: pp. 672-768 CrossRef
- Koffi, N, N’gom, A, Kouassi, B, Horo, K, Mansare, L, Aka-Danguy, E (2001) Évaluation de l’antibiothérapie probabiliste dans les pneumopathies aiguës d’allure bactérienne hospitalisées en milieu africain. Bull Soc Pathol Exot 94: pp. 397-400
- Pefura Yone, EW, Betyoumin, AF, Kengne, AP, Kaze Folefack, FJ, Ngogang, J (2011) First-line antiretroviral therapy and dyslipidemia in people living with HIV-1 in Cameroon: a cross-sectional study. AIDS Res Ther 8: pp. 33 CrossRef
- Pefura Yone, EW, Kengne, AP, Kuaban, C (2011) Incidence, time and determinants of tuberculosis treatment default in Yaounde, Cameroon: a retrospective hospital register-based cohort study. BMJ open 1: pp. e000289 CrossRef
- Bartlett, JG, Dowell, SF, Mandell, LA, File, TM, Musher, DM, Fine, JM (2000) Practice guidelines for the management of community-acquired pneumonia in adults. Infectious Diseases Society of America. Clin Infect Dis 31: pp. 347-382 CrossRef
- Lim, WS, van der Eerden, MM, Laing, R, Boersma, WG, Karalus, N, Town, GI, Lewis, SA, Macfarlane, JT (2003) Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax 58: pp. 377-382 CrossRef
- Report on HIV sentinel surveillance system in Cameroon. Ministry of Public Health, Yaoundé
- AIDS epidemic update.
- Sharma, SK, Kadhiravan, T, Banga, A (2009) A clinical prediction rule to identify patients with tuberculosis at high risk for HIV co-infection. Indian J Med Res 1: pp. 51-57
- Obirikorang, C, Yeboah, FA (2009) Blood haemoglobin measurement as a predictive indicator for the progression of HIV/AIDS in resource-limited setting. J Biomed Sci 16: pp. 102 CrossRef
- Pefura Yone, EW, Kuaban, C, Afane Ze, E, Simo, L (2011) Clinical characteristics, microbiologic findings and outcome of non-tuberculous purulent pleural effusion in HIV-infected and non HIV-infected adult patients in Yaounde, Cameroon. Rev Pneumol Clin.
- Feldman, C, Glatthaar, M, Morar, R, Mahomed, AG, Kaka, S, Cassel, M, Klugman, KP (1999) Bacteremic pneumococcal pneumonia in HIV-seropositive and HIV seronegative adults. Chest 116: pp. 107-114 CrossRef
- Johnson, DH, Carriere, KC, Houston, S (2003) Hospitalization for community- acquired pneumonia in Alberta patients with human immunodeficiency virus infection: a case control study. Can Respir J 10: pp. 265-270
- Falcó, V, Fernández de Sevilla, T, Alegre, J, Barbé, J, Ferrer, A, Ocaña, I, Ribera, E, Martínez-Vázquez, JM (1994) Bacterial pneumonia in HIV-infected patients: a prospective study of 68 episodes. Eur Respir J 7: pp. 235-239 CrossRef
- Mundy, LM, Auwaerter, PG, Oldach, D, Warner, ML, Burton, A, Vance, E, Gaydos, CA, Joseph, JM, Gopalan, R, Moore, RD (1995) Community acquired pneumonia: impact of immune status. Am J Respir Crit Care Med 152: pp. 1309-1315
- Feldman, C, Klugman, KP, Yu, VL, Ortqvist, A, Choiu, CC, Chedid, MB, Rello, J, Wagener, M (2007) Bacteraemic pneumococcal pneumonia: impact of HIV on clinical presentation and outcome. J Infect 55: pp. 125-135 CrossRef
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2466/12/46/prepub
- Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
BMC Pulmonary Medicine
- Online Date
- August 2012
- Online ISSN
- BioMed Central
- Additional Links
- Community-acquired pneumonia
- HIV infection
- Author Affiliations
- 1. Department of Internal Medicine and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon
- 2. Service of Pneumology, Yaounde Jamot Hospital, BP: 4021, Yaoundé, Cameroun
- 3. South African Medical research Council & University of Cape Town, Cape Town, South Africa