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Outcomes in Patients Diagnosed With H1N1 Not Affected by HIV Status: Presented at CROI By Ed Susman SAN FRANCISCO -- February 21, 2010 -- Patients with HIV who were also diagnosed with influenza A (H1N1) virus did not appear to have worse outcomes than people without HIV, researchers said here at the 17th Conference on Retroviruses and Opportunistic Infections (CROI). “HIV infection did not make H1N1 more severe, and H1N1 did not have a major effect on HIV infection,” said Esteban Martinez, MD, Hospital Clinic and University of Barcelona, Barcelona, Spain, in a presentation on February 18. Dr. Martinez reviewed outcomes among 623 people with confirmed H1N1. That group included 56 individuals who were also HIV-positive. The patients were all admitted to the hospital last fall (2009). For every HIV-positive patient diagnosed with H1N1, 3 consecutive HIV-negative individuals diagnosed with H1N1 in the same calendar week with randomly chosen as controls. The HIV-positive patients were mainly male, older, and smokers -- reflecting the population treated at Dr. Martinez’ hospital and suggesting influenza was not attacking any particular segment of HIV-positive people. The CD4-positive cell count of HIV-positive patients as well as the level of detectable virus in their blood did not significantly change from pre-infection with H1N1 figures. Clinical features were generally similar. However, 37% of HIV-positive patients with H1N1 had digestive symptoms, compared with 18% of HIV-negative patients (P = .004) Also, patients with HIV were less likely to have pneumonia and respiratory failure; about 9% of patients with HIV had pneumonia compared with 25% of HIV-negative patients (P = .01). About 9% of the patients with HIV experienced respiratory failure compared with 21% of the HIV-negative patients (P = .04). Rates of complications after H1N1 diagnosis were similar -- 12% for HIV-positive patients versus 11% for patients without HIV. No patients with HIV and H1N1 died, although 2% of HIV-negative patients did. Among the HIV-positive patients, median CD4 counts and HIV viral loads did not differ before and after the flu. “We don’t know why the HIV-positive patients appeared to do a little better than the HIV-negative patients who were infected with H1N1 influenza,” said Dr. Martinez during a press briefing. He speculated that one possibility is that HIV-positive patients might be more inclined to report illnesses to doctors and therefore were treated at an earlier point in the influenza infection. [Presentation title: 2009 H1N1 Virus Infection in HIV+ Adults. Abstract 802LB] E-mail this page to a friend or colleague! To print, use this version