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Clinical Presentation of 2009 H1N1 Influenza A Disease in HIV-Infected Patients: Experience From a Large AIDS Center in New York City

Gonzalez, Efrain MD*†; Psevdos, George Jr MD*†; Tsveniashvili, Lia MD*†; Sharp, Victoria MD

Infectious Diseases in Clinical Practice: September 2011 - Volume 19 - Issue 5 - p 340-342
doi: 10.1097/IPC.0b013e3182142fa6
Original Articles

Background: H1N1-novel Influenza A seemed to take the United States by surprise in the summer of 2009, and it soon reached epidemic proportions, affecting large and varied sections of the population. Immune-compromised patient populations, including human immunodeficiency virus (HIV)-infected individuals, were thought to be at higher risk. The study examined the severity and characteristics of H1N1 Influenza disease in HIV-infected patients and assessed treatment outcomes.

Methods: Retrospective chart review of 2951 HIV-infected patients from May 1, 2009 to December 31, 2009.

Results: Ninety-four patients presented with flulike symptoms, and 25 patients tested positive by culture for H1N1. Only 4 of 25 rapid test results were positive. The mean age was 46 years. Ninety-two percent were on antiretroviral therapy, and 56% were men. The mean CD4+ T-cell count was 496/μL, and viral load was undetectable in 60% of the patients. Ten patients required hospitalization, and 3 received mechanical ventilation. One patient died. Twenty-four patients received osetalmivir, and one patient recovered without treatment. There was no difference between the hospitalized and nonhospitalized patients in the CD4+ T-cell count (P = 0.8462) and viral load (P = 0.5849). Hospitalized patients were older (mean age, 54.3 vs. 41.5 years, P = 0.001), and logistic regression analysis showed that age older than 46 years (OR = 18.000; 95% confidence interval, 1.75-184.68, P = 0.032) was associated with hospitalization.

Conclusions: H1N1 influenza was a rare occurrence in our population. Most of the patients recovered. Older patients were more likely to get hospitalized.

From the *Department of Infectious Diseases, St Luke's Roosevelt Medical Center (an affiliate of Columbia University College of Physicians and Surgeons) and †Center for Comprehensive Care, New York, NY.

Correspondence to: George Psevdos Jr, MD, Center for Comprehensive Care, Suite 2T, 1000 10th Ave, New York, NY 10019. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2011 Lippincott Williams & Wilkins, Inc.