Influence of HIV infection on the clinical presentation and outcome of adults with acute community-acquired pneumonia in Yaounde, Cameroon: a retrospective hospital-based study

Abstract

BACKGROUND: The impact of HIV infection on the evolution of acute community-acquired pneumonia (CAP) is still controversial. The aim of this study was to investigate possible differences in the clinical presentation and in-hospital outcomes of patients with CAP with and without HIV infection in a specialised service in Yaounde. METHODS: Medical files of 106 patients (51 men) aged 15years and above, admitted to the Pneumology service of the Yaounde Jamot Hospital between January 2008 and May 2012, were retrospectively studied. RESULTS: Sixty-two (58.5%) patients were HIV infected. The median age of all patients was 40years (interquartile range: 31.75-53) and there was no difference in the clinical and radiological profile of patients with and without HIV infection. The median leukocyte count (interquartile range) was 14,600/mm3 (10,900-20,600) and 10,450/mm3 (6,400-16,850) respectively in HIV negative and HIV positive patients (p=0.002). Median haemoglobin level (interquartile range) was 10.8g/dl (8.9-12) in HIV negative and 9.7g/dl (8-11.6) in HIV positive patients (p=0.025). In-hospital treatment failure on third day (39.5% vs. 25.5.1%, p=0.137) and mortality rates (9% vs. 14.5%, p=0.401) were similar between HIV negative and HIV positive patients. CONCLUSION: Clinical and radiological features as well as response to treatment and in hospital fatal outcomes are similar in adult patients hospitalised with acute community-acquired pneumonia in Yaounde. In contrast, HIV infected patients tend to be more anaemic and have lower white cell counts than HIV negative patients. Larger prospective studies are needed to consolidate these findings.