Study: Virally suppressed HIV does not increase mortality risk with pneumonia
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Key takeaways:
- People with HIV who are on ART have a similar risk for death from pneumonia as people who do not have HIV.
- People with HIV who have AIDS have a higher mortality risk than people with HIV without AIDS.
People with virally suppressed HIV who are hospitalized with community acquired pneumonia do not have a higher mortality risk than people without HIV, according to a study.
“HIV status by itself, especially if well controlled on antiretroviral therapy, should not be considered a poor prognostic factor when clinicians risk stratify patients with community acquired pneumonia regarding decisions on hospital or ICU admission or discharge,” Anthony Bai, MD, MSc, assistant professor in the infectious diseases division of the department of medicine at Queen’s University in Kingston, Canada, told Healio.
Roughly three-quarters of people globally living with HIV are on ART, with many of them virally suppressed, according to UNAIDS. As a result, many people with HIV are living longer lives and fewer are dying of AIDS-related causes.
Bai and colleagues analyzed data on 82,822 people diagnosed with community-acquired pneumonia (CAP) at 31 acute-care hospitals in Ontario, Canada, between Jan. 1, 2015, and July 1, 2022, roughly 1,500 of whom (1.8%) also had a diagnosis of HIV.
Among people admitted to the hospital, 67 (4.4%) people with HIV and 6,873 (8.5%) people without HIV died after a CAP diagnosis.
According to the study, HIV status had an adjusted subdistribution hazard ratio (sHR) of 1.02 (95% CI, 0.8-1.31) of dying in the hospital. Of patients with HIV, 440 (29%) had been diagnosed with AIDS, a diagnosis of which had an adjusted sHR of 3.04 (95% CI 1.69-5.45) for dying in the hospital compared with people with HIV without AIDS.
The researchers concluded that people with and without HIV admitted to the hospital with CAP had a similar in-hospital mortality rate and suggested that new CAP guidelines should consider this finding.
“The finding is reassuring in that HIV, if well controlled on antiretroviral therapy, likely does not put the patient at a higher risk of mortality for pneumonia,” Bai said.
References:
- Bai AD, et al. Clin Infect Dis. 2024;doi:10.1093/cid/ciae393.
- New UNAIDS report shows AIDS pandemic can be ended by 2030, but only if leaders boost resources and protect human rights now. https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2024/july/20240722_global-aids-update. Published July 22, 2024. Accessed Aug. 16, 2024.
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