STUDY OF 164 INFECTIVE ENDOCARDITIS EPISO DES IN DRUG-ADDICT PATIENTS- COMPARISON BETWEEN HIV-POSITIVE AND HIV-NEGATIVE PATIENTS

Objective. Intravenous drug-addicts (IVDA) are the most important risk group for acquiring HIV and developing infective endocarditis (IE) in Spain. The clinical and evolutive features of a large series of IE in HIV-infected IVDA are reported and compared with those observed in a smaller group of patients without HIV infection. Methods. A retrospect ive analysis was made of 164 episodes of IE from 136 patients diagnose d in a Service of Infectious Diseases in Madrid (1986-1992). IE was de fined according to the modified Von Reyn criteria and only the probabl e and definite IE episodes were evaluated. Results. A total of 143 IE episodes occurred in 117 IVDA infected with HIV (group A) and 21 episo des in 19 HIV-negative patients (group B). Most of seropositive patien ts were asymptomatic carriers of HIV (54%) and only 22% had AIDS. The IE onset was acute for 97% patients in group A and 81% in group B, wit h fever and respiratory symptoms as main complaints. Chest X-ray was n ormal in 19% of cases in group A and in 28% in group B. Septic embolis ms were observed in 56% and 41% of patients in group A and B, respecti vely. The vegetation originated mainly on the tricuspid valve and Stap hylococcus aureus was recovered from most blood-cultures. The mortalit y rate was similar in both groups, 6% and 5% in groups A and B, respec tively. Conclusions. Most IVDA with IE were HIV-positive patients in t his series. IE is usually reported in the early stages of HIV infectio n and apparently its presence has no influence on the clinical course of IE.