Volume 19, Number 11—November 2013
Research
Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009–2011
Table 2
Characteristic | HIV-infected patients† | HIV-uninfected patients† | Univariate analysis |
Multivariable analysis |
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---|---|---|---|---|---|---|---|
OR (95% CI) | p value | OR (95% CI) | p value | ||||
Patient demographics | |||||||
Age group, y | <0.001 | <0.001 | |||||
<5 | 45/358 (13) | 290/461 (63) | Referent | Referent | |||
5–24 | 38/358 (11) | 44/461 (10) | 5.6 (3.3–9.5) | 4.4 (2.4–8.2) | |||
25–44 | 212/358 (59) | 39/461 (8) | 35.0 (22.0–55.7) | 24.2 (14.1–41.7) | |||
45–64 | 61/358 (17) | 52/461 (11) | 7.6 (4.7–12.3) | 6.2 (3.4–11.3) | |||
>65 | 2/358 (1) | 36/461 (8) | 0.4 (0.1–1.5) | 0.2 (0.04–0.9) | |||
Female sex | 253/358 (71) | 224/461 (49) | 2.5 (1.9–3.4) | <0.001 | 1.9 (1.2–2.8) | 0.003 | |
Black African race |
353/358 (99) |
445/460 (97) |
2.4 (0.9–6.6) |
0.096 |
4.0 (1.1–14.6) |
0.036 |
|
Year of hospitalization | 0.002 | ||||||
2009 | 88/358 (25) | 151/461 (33) | Referent | ||||
2010 | 127/358 (35) | 114/461 (25) | 1.9 (1.3–2.8) | ||||
2011 |
143/358 (40) |
196/461 (43) |
1.3 (0.9–1.8) |
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Co-infections and underlying medical conditions | |||||||
Underlying condition excluding tuberculosis and HIV‡ | 25/358 (7) | 47/461 (10) | 0.7 (0.4–1.1) | 0.109 | 0.4 (0.2–0.8) | 0.008 | |
Smoking§ | 32/299 (11) | 24/151 (16) | 0.6 (0.4–1.1) | 0.117 | |||
Consumed alcohol§ | 28/299 (9) | 26/151 (17) | 0.5 (0.3–0.9) | 0.017 | |||
Underlying tuberculosis | 60/357 (17) | 19/461 (4) | 4.7 (2.7–8.0) | <0.001 | |||
Pneumococcal co-infection on PCR¶ | 37/345 (11) | 17/389 (4) | 2.7 (1.5–5.0) | <0.001 | 2.3 (1.0–5.0) | 0.043 | |
Viral respiratory co-infection# | 82/358 (23) | 152/456 (33) | 0.6 (0.4–0.8) | 0.001 | |||
Influenza type B (vs. A) | 148/358 (41) | 133/461 (29) | 1.7 (1.3–2.3) | <0.001 | 1.6 (1.0–2.4) | 0.035 | |
Received >2 doses of pneumococcal
conjugate vaccine** |
3/39 (8) |
53/242 (22) |
0.3 (0.1–1.0) |
0.051 |
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Clinical findings and treatment course | |||||||
Symptoms >2 d before admission | 296/358 (83) | 295/461 (64) | 2.7 (1.9–3.7) | <0.001 | |||
Admission to intensive care | 0/357 (0) | 6/461 (1) | Undefined | 0.031 | |||
Mechanical ventilation | 2/357 (1) | 4/461 (1) | 0.6 (0.1–3.5) | 0.612 | |||
Oxygen required | 142/357 (40) | 141/461 (31) | 1.5 (1.1–2.0) | 0.006 | |||
Antimicrobial drugs prescribed at admission | 351/358 (98) | 438/460 (95) | 2.5 (1.1–6.0) | 0.036 | |||
Duration of hospitalization, d | <0.001 | <0.001 | |||||
<2 | 20/352 (6) | 149/460 (32) | Referent | Referent | |||
2–7 | 217/352 (62) | 241/460 (52) | 6.7 (4.1–11.1) | 2.8 (1.5–5.5) | |||
>7 | 115/352 (33) | 70/460 (15) | 12.2 (7.0–21.3) | 4.5 (2.1–9.5) | |||
Median duration of hospitalization, d (range) | 6 (4–8) | 3 (1–6) | 1.1 (1.05–1.13) | <0.001 | |||
Case-fatality rate | 19/356 (5) | 6/461 (1) | 4.3 (1.7–10.8) | 0.002 | 3.9 (1.1–14.1) | 0.038 |
*ORs and p values are shown for all variables included in the multivariable model. LRTI, lower respiratory tract infection; OR, odds ratio.
†Values are no. patients/total no. in category (%) except as indicated. Some data are missing or were not recorded.
‡Asthma, other chronic lung disease, chronic heart disease (valvular heart disease, coronary artery disease, or heart failure excluding hypertension), liver disease (cirrhosis or liver failure), renal disease (nephrotic syndrome, chronic renal failure), diabetes mellitis, immunocompromising conditions excluding HIV infection (organ transplant, immunosuppressive therapy, immunoglobulin deficiency, malignancy), neurologic disease (cerebrovascular accident, spinal cord injury, seizures, neuromuscular conditions) or pregnancy. Coexisting illnesses were considered absent in cases for which the medical records stated that the patient had no underlying medical condition or when there was no direct reference to that condition.
§Question asked of patients >12 y of age only.
¶Three additional cases of Streptococcus pneumoniae on blood culture not included
#Co-infection with influenza and >1 of the following: parainfluenza virus 1, 2, or 3; respiratory syncytial virus; enterovirus; human metapneumovirus; adenovirus; rhinovirus.
**Verified only for children <5 y of age.