[Historical cohort study on bacterial pneumonias as predictors of the progression of the human immunodeficiency virus disease].

BACKGROUND

Recognition of the importance of bacterial pneumonias in the context of HIV infection has continuously grown throughout the pandemia. It has recently been suggested that these may be predictors of progression of the disease.

PATIENTS AND

METHODS

The evolution of an historic cohort of patients with HIV infection who were studied in 1989 with pneumonia regarding the presentation of AIDS or death was investigated. A control cohort was established, being age matched for sex, CD4 lymphocyte count, previous HIV disease and the use of zidovudine. Kaplan-Meier curves of survival without AIDS were made and compared by the logarythmic range test. Other predictors of progression were studied by the Cox models.

RESULTS

Forty-nine patients were studied in each group, with a total of 121 and 153 patients/year of follow up. Final events were counted in 33 and 27 cases, respectively (p = 0.11). The relative risk of progression was 1.55 (confidence interval of 95%, 0.93 to 2.56) for the group of pneumonias. The estimated relative risk (hazard) performed by a Cox model of proportional risks was however 1.85 (confidence interval of 95%: 1.05 to 3.25, p < 0.05) when the lymphocyte count adjustment was carried out according to the real values rather than by categories.

CONCLUSIONS

The results of this historic cohort study support the existence of an association between history of bacterial pneumonia and the risk of HIV disease progression.