Volume 17, Number 6—June 2011
Letter
Pandemic (H1N1) 2009 and HIV Infection
Shireesha Dhanireddy
, Robert D. Harrington, Heidi M. Crane, Matthew R. Gingo, Alison Morris, Laurence Huang, and Kristina Crothers
, Robert D. Harrington, Heidi M. Crane, Matthew R. Gingo, Alison Morris, Laurence Huang, and Kristina CrothersTable
Baseline characteristics for HIV-infected patients with pandemic (H1N1) 2009, Seattle, Washington, USA, 2009*
| Patient characteristics | All patients, n = 23 | Inpatients, n = 8 | Outpatients, n = 15 | p value† |
|---|---|---|---|---|
| Demographics | ||||
| Male sex | 19 (83) | 5 (63) | 14 (93) | 0.1 |
| Median age, y (range) | 43 (22–72) | 46 (34–72) | 42 (22–64) | 0.5 |
| Race/ethnicity | 1.0 | |||
| White | 14 (61) | 5 (63) | 9 (60) | |
| Black | 5 (22) | 2 (25) | 3 (20) | |
| Hispanic | 4 (17) | 0 | 4 (27) | 1.0 |
| Other/refused to answer |
4 (17) |
1 (13) |
3 (20) |
|
| History | ||||
| Received 2009–10 seasonal influenza vaccine before illness | 14 (61) | 6 (75) | 8 (53) | 0.1 |
| Ever smoked |
15 (65) |
7 (88) |
8 (53) |
0.2 |
| HIV-associated factors | ||||
| CD4 count, cells/µL, median (range) | 308 (32–1,024) | 147 (32–1,024) | 438 (119–833) | 0.06 |
| Undetectable HIV-1 RNA | 19 (83) | 6 (75) | 13 (87) | 0.6 |
| Receiving antiretroviral therapy |
21 (91) |
8 (100) |
13 (87) |
0.5 |
| Predisposing risk factors | 15 (65) | 6 (75) | 9 (60) | 0.5 |
| Prior lung disease | 8 (35) | 5 (63) | 3 (20) | 0.07 |
| Cardiovascular disease | 4 (17) | 3 (38) | 1 (6.7) | 0.1 |
| Obesity, body mass index >30 | 4 (17) | 1 (13) | 3 (20) | 1.0 |
| Neutropenia | 3 (13) | 2 (25) | 1 (6.7) | 0.3 |
| Receiving immunosuppressive agent | 3 (13) | 3 (38) | 0 | 0.03 |
| Malignancy | 4 (17) | 2 (25) | 2 (13) | 0.6 |
| Diabetes |
2 (8.7) |
0 |
2 (13) |
0.5 |
| Signs and symptoms | ||||
| Fever | 18 (78) | 7 (88) | 11 (73) | 0.6 |
| Fatigue | 5 (22) | 2 (25) | 3 (20) | 1.0 |
| Malaise | 11 (48) | 7 (88) | 4 (27) | 0.009 |
| Myalgia | 10 (43) | 3 (38) | 7 (47) | 1.0 |
| Sore throat | 5 (22) | 2 (25) | 3 (20) | 1.0 |
| Cough | 21 (91) | 8 (100) | 13 (87) | 0.5 |
| Dyspnea | 8 (35) | 4 (50) | 4 (27) | 0.4 |
| Nausea/vomiting | 10 (43) | 2 (25) | 8 (53) | 0.4 |
| Median duration of symptoms before seeking care, d (range) |
4 (0–30) |
4.5 (0–10) |
3 (1–30) |
0.6 |
| Physical examination findings | ||||
| Median temperature, °C (range) | 38.0 (35.7–40.2) | 39.1 (37.3–40.2) | 37.7 (35.7–38.5) | 0.001 |
| Median heart rate, beats/min (range) | 96 (69–129) | 109 (80–127) | 94 (69–129) | 0.1 |
| Mean arterial blood pressure, mm Hg (range) | 94 (66–116) | 89 (66–98) | 97 (75–116) | 0.05 |
| Median respiratory rate, breaths/min (range) | 20 (14–40) | 22 (18–40) | 19 (14–36) | 0.04 |
| Abnormal lung sounds |
11 (48) |
8 (100) |
3 (23) |
0.001 |
| Laboratory findings | ||||
| Leukocyte count, cells × 109/L (range) | 4.53 (0.53–10.8) | 3.2 (0.53–10.8) | 5.4 (2.8–9.4) | 0.4 |
| Leukopenia, <5,000 cells/µL |
9 (39) |
5 (63) |
4 (40) |
0.6 |
| Chest radiograph findings, new infiltrate |
6 (26) |
5 (63) |
1 (13) |
0.1 |
| Care received | ||||
| Antiviral treatment for influenza | 21 (91) | 8 (100) | 13 (87) | 0.5 |
| Intensive care unit admission | 3 (13) | 3 (38) | NA | |
| Mechanical ventilation | 2 (8.7) | 2 (25) | NA | |
| Vasopressors |
2 (8.7) |
2 (25) |
NA |
|
| Outcomes | ||||
| Secondary pneumonia | 3 (13) | 3 (38) | 0 | 0.03 |
| Thrombotic complications | 1 (4.6) | 1 (13) | 0 | 0.4 |
| Died | 2 (8.7) | 2 (25) | 0 | 0.1 |
*Values are no. (%) patients except as indicated. Among the 15 outpatients, 13 had a lung examination documented, 10 had a leukocyte count performed, and 8 had a chest radiograph taken. NA, not applicable.
†For comparison of characteristics between inpatients and outpatients.
