Respiratory virus-associated infections in HIV-infected adults admitted to the intensive care unit for acute respiratory failure: a 6-year bicenter retrospective study (HIV-VIR study)

Elabbadi, Alexandre; Pichon, Jérémie; Visseaux, Benoit; Schnuriger, Aurélie; Bouadma, Lila; Philippot, Quentin; Patrier, Juliette; Labbé, Vincent; Ruckly, Stéphane; Fartoukh, Muriel; Timsit, Jean-François; Voiriot, Guillaume

doi:10.1186/s13613-020-00738-9

Annals of Intensive Care

Table 1 Baseline characteristics, behavior during ICU stay, and outcome of 123 HIV-infected patients admitted to the ICU for acute respiratory failure, according to the CD4 lymphocyte count on the ICU admission

From: Respiratory virus-associated infections in HIV-infected adults admitted to the intensive care unit for acute respiratory failure: a 6-year bicenter retrospective study (HIV-VIR study)

Patients	All patients (n = 123)	CD4 ≤ 200 (n = 66)	CD4 > 200 (n = 57)	p value^a
Age (year)	51 [43–59]	46 [39–56]	55 [47–59]	< 0.01
Sex male	82 (66.7)	40 (60.6)	42 (73.7)	0.12
Smoking	49 (41.2)	24 (38.7)	25 (43.9)	0.57
WHO performance status > 0	61 (50.8)	33 (50.7)	28 (50.9)	0.99
COPD GOLD III–IV	16 (13)	4 (6.1)	12 (21.1)	0.01
Arterial hypertension	32 (26)	13 (19.7)	19 (33.3)	0.09
Coronary heart disease	19 (15.4)	10 (15.2)	9 (15.8)	0.92
Baseline HIV-related characteristics
Newly diagnosed HIV infection	11 (8.9)	10 (15.2)	1 (1.8)	0.92
HIV viral load (log)^b	0 [0–3.4]	4.7 [1.2–5.4]	0 [0–1.4]	< 0.01
CD4 lymphocyte count (cells/µL)^c	351 [140–600]	72 [30–200]	517 [406–715]	< 0.01
ART	88 (72.1)	33 (50.8)	55 (96.5)	< 0.01
Steroid therapy^d	4 (3.3)	2 (3)	2 (3.5)	0.85
Other immunosuppressive treatments	2 (1.6)	1 (1.5)	1 (1.8)	0.92
Splenectomy	1 (0.8)	0	1 (1.8)	0.28
Cancer or hematologic malignancy	6 (4.9)	1 (1.5)	5 (8.8)	0.06
Chemotherapy	2 (1.6)	1 (1.5)	1 (1.8)	0.92
Organ/bone marrow transplantation	(0.8)	1 (1.5)	0	0.35
Transfer from another ward^e	62 (50.4)	30 (45.5)	32 (56.2)	0.24
SOFA score	4 [2–7]	4 [2–8]	3 [2–6]	0.60
SAPS II score	44 [34–57]	44 [37–57]	41 [31–55]	0.20
Biology on ICU admission
HIV viral load (log)^f	2.5 [0–5.3]	5 [2.9–5.6]	0 [0–2]	< 0.01
CD4 lymphocyte count (cells/µL)	170 [20–430]	29 [10–102]	461[345–533]	< 0.01
Neutrophil count (G/L)	6.7 [3.9–9]	5.5 [2.1–7.6]	7.6 [5.3–12.1]	< 0.01
Procalcitonin (µg/L)^g	0.6 [0.2–5.9]	0.6 [0.2–3]	0.5 [0.1–8.3]	0.89
Lactate dehydrogenase (U/L)	403 [276–637]	471 [325–675]	327 [233–575]	0.02
Organ supports during ICU stay
High-flow nasal cannula oxygen	36 (29.2)	24 (36.3)	12 (21)	0.06
Noninvasive ventilation	30 (24.8)	11 (17.1)	19 (33.3)	0.04
Mechanical ventilation	43 (35.2)	24 (36.9)	19 (33.3)	0.68
Vasopressor	36 (29.3)	22 (33.3)	14 (24.6)	0.29
Renal replacement therapy	23 (18.7)	14 [21.2)	9 (15.8)	0.44
Outcome
ICU length of stay (day)	7 [4–12]	7 [3.3–16.8]	6 [3–11]	0.21
Day-28 mortality^h	15 (12.2)	8 (12.1)	7 (12.3)	0.98
Complicated courseⁱ	30 (24.4)	17 (25.8)	13 (22.8)	0.70

Data are presented as median [first through third quartiles] or number (%). CD4 refers to CD4 lymphocyte count (cells/µL)
HIV Human immunodeficiency virus, ICU Intensive care unit, SAPS II Simplified Acute Physiologic Score II, SOFA Sepsis-related Organ Failure Assessment, WHO World Health Organization
^a P values refer to differences between Low-CD4 (≤ 200 cells/µL) and High-CD4 (> 200 cells/µL) groups in univariate logistic regression
^bData were available for 76 patients
^cData were available for 81 patients
^d≥ 10 mg of prednisone (or equivalent) per day for more than 30 days
^eTransfer from another ward included transfers from another ICU and from the medical wards
^fData were available for 101 patients
^gData were available for 79 patients
^hMortality was defined as death from any cause within 28 days following the ICU admission
ⁱComplicated course was defined as death from any cause within 28 days following the ICU admission and/or mechanical ventilation > 7 days

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