STREPTOCOCCUS-PNEUMONIAE AND HIV-INFECTIO N - A RETROSPECTIVE STUDY OF 41 EPISODES OF BACTEREMIA IN 30 PATIENTS

Objectives: Pulmonary infections and bacteraemia, essentially due to S treptococcus pneumoniae and Haemophilus influenzae, are frequently rep orted in patients infected with the human immunodeficiency virus (HPV) . We retrospectively analyzed episodes of bacteraemia in HIV-infected patients to determine whether supplementary risk factors could be asce rtained and whether it would be advisable to propose vaccination. Meth ods: From June 1986 to February 1992, 41 episodes of bacteraemia in 30 HIV-infected patients were observed in 7 different wards. Data on age , sex, risk group, Centers for Disease Control classification, CD4 cou nts and clinical outcome were recorded. Results: There were 18 males a nd 12 females, mean age 34 years (range 26-67 years) in CDC class II ( n=11), III (n=5) and IV (n=16). There were 17 intravenous drug users ( 56.6%). There were 8 heterosexuals (26%), 3 homosexuals or bisexuals ( n=3) and 2 patients infected after blood transfusions (6%). All the he terosexual patients were of black-African or Carabean ethnic origin. M ean CD4 count was 239 mm(3) (range 2 - 1148) during the episode of bac teraemia which occurred during an upper respiratory tract infection in 96% of the patients. Recurrent episodes were observed in 7 patients. Outcome of the infectious episode was favourable in 35/41 cases after antibiotic therapy. Six patients (all CDC class TV) died during the ep isode of bacteraemia.