1392. HIV-infected Hospitalized Patients with Influenza: Data from a National Medical Claims Database – United States, 2007 – 2010
Session: Oral Abstract Session: Complications of HIV
Sunday, October 23, 2011: 7:45 AM
Room: 151AB

Background: Influenza occurs frequently among HIV-infected adults but risk factors for severe illness among these patients are not well defined.

Methods: We performed a cross-sectional analysis of influenza hospitalizations during three influenza seasons [2007/08; 2008/09; and 2009/10] using SDI's National Medical Claims Database.  We evaluated adults (aged 18-64 years) hospitalized with an ICD-9 code for influenza, for whom we abstracted data including demographics, medical conditions, clinical outcomes, select laboratory results, and treatment.  We defined HIV infection by the presence of corresponding ICD-9 codes and illness as severe if it required mechanical ventilation, intensive care unit admission, or resulted in death.

Results: Among 11,262 adults hospitalized with influenza during three influenza seasons, 410 (3.5%) were HIV-infected.  HIV-infected patients comprised a smaller fraction of hospitalized patients during the pandemic 2009/10 season (306/9462; 3.2%) than the prior two non-pandemic seasons (104/2202; 4.7%; p<0.001).  HIV-infected and HIV-uninfected patients had similar frequencies of severe illness (19% vs. 21%; p=0.27) and in multivariable models including all patients, HIV infection was not associated with severe illness (adjusted odds ratio [aOR] = 0.9; 95% confidence interval [CI] = 0.7 – 1.1).  In separate multivariable models for HIV-infected and for HIV-uninfected patients, severe illness was associated with chronic medical conditions (aORs = 4.3 [95% CI = 2.2 – 8.5] and 2.0 [95% CI = 1.8 – 2.2] respectively) and hospitalization in the South compared with elsewhere (aORs = 2.7 [95% CI = 1.5 – 4.9] and 1.2 [95% CI = 1.1 – 1.3] respectively).  Overall, 244 (60%) HIV-infected patients received influenza antiviral therapy; that percentage was higher during the pandemic compared with non-pandemic seasons (64% vs. 46%; p=0.002).  Forty-two (74%) of 57 patients with available CD4 cell counts had a value >200 cells/mL. 

Conclusion: HIV infection alone was not associated with a greater risk of severe influenza illness.  Having a chronic medical condition and having been hospitalized in the South, however, conferred substantially greater odds of severe illness for HIV-infected compared with HIV-uninfected patients.


Subject Category: H. HIV/AIDS and other retroviruses

Philip J. Peters, MD1, Kate Buchacz, PhD1, Seema Jain, MD1, Farid Khan, MPH2, Ed Burleigh2, Eric J. Kasowski, DVM, MD, MPH1, Kathy DeMonde2, Laurel Edelman, BSc(Adv)2 and John T. Brooks, MD3, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)SDI Health, Plymouth Meeting, PA, (3)Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

P. J. Peters, None

K. Buchacz, None

S. Jain, None

F. Khan, SDI Health: Employee, Salary

E. Burleigh, SDI Health: Employee, Salary

E. J. Kasowski, None

K. DeMonde, SDI Health: Employee, Salary

L. Edelman, SDI Health: Employee, Salary

J. T. Brooks, None

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