Authors: Alizamin Sadigov.
Assessment of risk factors which may predict poor outcomes for patients with community-acquired pneumonia (CAP) in individuals with HIV is important for further evaluation of possibility their modification and through that the reduction mortality rate and improved patient outcomes. We aimed to investigate the risk factors for CAP in patients with HIV infection in term on their modification and through that reduction associated poor outcomes in such patients. We conducted a retrospective cohort study involving patients with diagnosed CAP who were admitted to the pulmonary and critical care medicine unit at medical university hospital, Baku city, Azerbaijan, between January of 2018 and December of 2022. One hundred ninety three adults (>18 years) patients with CAP were enrolled to the study. Pneumonia was diagnosed as CAP when it occurs before 48 h of hospital admission, 59 of 193 patients with CAP pneumonia was developed in individuals with HIV infection, and 16 of them the HIV infection was diagnosed accidently in our hospital. We have found five major and independent risk factors predicting in-hospital mortality in such patients: severe malnutrition; CD4 count <100 cells/mm3 ; radiographic progression of the disease with P/F<250; bacteremia; and severe sepsis/septic shock. In our study the presence of HIV infection in CAP patients is associated with an increased risk of ICU admission with an increased risk of inhospital mortality (2.5[0.94-5.6]; p<.02). We found a several risk factors in our sample, related to development of bacterial pneumonia in individuals with HIV infection. We found a high burden of comorbidities commonly related to chronic kidney failure and severe malnutrition as well as considerable high in-hospital mortality in such patients. We identified factors associated with an increased risk of ICU admission and fatal outcomes which could help identify patients who might benefit from anti-pneumococcal vaccination, adequate nutrition and antiretroviral therapy, as well as determine prognosis. Our findings should be validated by studies with larger samples of patients.
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