NEUTROPENIA IS ASSOCIATED WITH BACTEREMIA IN PATIENTS INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

Neutropenia occurs in approximately 17% of symptomatic patients infect ed with HIV. Results of studies have failed to demonstrate a consisten t relationship between HIV-related neutropenia and the subsequent deve lopment of bacterial infections, This was a case control study to dete rmine if HIV-related neutropenia was associated with increased rates o f bacteremia. The experimental group was comprised of 29 patients infe cted with HIV that had an absolute neutrophil count less than 1000 cel ls/mm(3) 3 and were paired with 29 control subjects infected with HIV that had been matched for age, sex, CD4 count, and month and year of e ntry, The frequency of bacteremia was 12.6 per 100 patient months amon g the experimental group compared to a frequency of 0.87 per 100 patie nt months among the control group (relative risk [RR] = 14.9, P = 0.00 27). Other independent risks for the development of bacteremia include d central venous catheters (RR = 3.9, P = 0.03), with a trend toward i ncreased risk for bacteremia in those patients who were intravenous dr ug users (RR = 3.8, P = 0.11), or who had infiltrative bone marrow dis ease (RR = 3.1, P = 0.11), Multivariate analysis demonstrated that neu tropenia (odds ratio [OR] = 22.6, P = 0.028) and the presence of a cen tral venous catheter (OR = 8.5, P = 0.026) were significant risks for bacteremia. These data suggest that neutropenia is a significant risk for the development of bacteremia in patients infected with HIV.