| Title | 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). | ||
| Author | Elabbadi, Alexandre; Pichon, Jeremie; Visseaux, Benoit; Schnuriger, Aurelie; Bouadma, Lila; Philippot, Quentin; Patrier, Juliette; Labbe, Vincent; Ruckly, Stephane; Fartoukh, Muriel; Timsit, Jean-Francois; Voiriot, Guillaume | ||
| Journal | Ann Intensive Care | Publication Year/Month | 2020 |
| PMID | 32953200 | PMCID | PMC7488215 |
| Affiliation | 1.Assistance Publique - Hopitaux de Paris, Service de medecine intensive reanimation, Hopital Tenon, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;Assistance Publique - Hopitaux de Paris, Service de medecine intensive reanimation, Hopital Tenon, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;Assistance Publique - Hopitaux de Paris, Service de virologie, Hopital Bichat, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;INSERM, Saint-Antoine Research Center (CRSA), Assistance Publique - Hopitaux de Paris, Departement de virologie site Trousseau, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;Assistance Publique - Hopitaux de Paris, Service de reanimation medicale et infectieuse, Hopital Bichat, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;Assistance Publique - Hopitaux de Paris, Service de medecine intensive reanimation, Hopital Tenon, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;Assistance Publique - Hopitaux de Paris, Service de reanimation medicale et infectieuse, Hopital Bichat, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;Assistance Publique - Hopitaux de Paris, Service de medecine intensive reanimation, Hopital Tenon, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;Groupe de Recherche Clinique GRC05 CARMAS, Institut Mondor de recherche biomedicale, INSERM, Universite Paris Est, Creteil, France.grid.410511.00000 0001 2149 7878;UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;Assistance Publique - Hopitaux de Paris, Service de medecine intensive reanimation, Hopital Tenon, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;Groupe de Recherche Clinique GRC05 CARMAS, Institut Mondor de recherche biomedicale, INSERM, Universite Paris Est, Creteil, France.grid.410511.00000 0001 2149 7878;UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases control and care, INSERM, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;Assistance Publique - Hopitaux de Paris, Service de reanimation medicale et infectieuse, Hopital Bichat, Universite de Paris, Paris, France.grid.5842.b0000 0001 2171 2558;Assistance Publique - Hopitaux de Paris, Service de medecine intensive reanimation, Hopital Tenon, Sorbonne Universite, Paris, France.grid.462844.80000 0001 2308 1657;Groupe de Recherche Clinique GRC05 CARMAS, Institut Mondor de recherche biomedicale, INSERM, Universite Paris Est, Creteil, France.grid.410511.00000 0001 2149 7878. | ||
INTRODUCTION: Acute respiratory failure is the main reason for admission to the intensive care unit (ICU) in HIV-infected adults. There is little data about the epidemiology of respiratory viruses in this population. METHODS: HIV-infected adults admitted to two intensive care units over a 6-year period for an acute respiratory failure and explored for respiratory viruses with multiplex polymerase chain reaction (mPCR) were retrospectively selected. Objectives were to describe the prevalence of respiratory viruses, coinfections with non-viral pathogens, and hospital outcome. RESULTS: A total of 123 episodes were included. An HIV infection was newly diagnosed in 9% of cases and 72% of the population were on antiretroviral therapy. Real-time mPCR tests identified at least one respiratory virus in the respiratory tract of 33 (27%) patients, but with a non-viral copathogen in two-thirds of cases. Rhinovirus was predominant, documented in 15 patients, followed by Influenza and Respiratory Syncytial Viruses (both n = 6). The prevalence of respiratory virus-associated infection did not vary along with the level of the CD4 T-cell deficiency, except for Rhinovirus which was more prevalent in patients with a CD4 lymphocyte count below 200 cells/microL (n = 13 (20%) vs. n = 2 (4%), p < 0.01). In multivariate analysis, respiratory virus-associated infection was not associated with a worse prognosis. CONCLUSIONS: Viruses are frequently identified in the respiratory tract of HIV-infected patients with acute respiratory failure that requires ICU admission, but with a non-viral copathogen in two-thirds of cases. Rhinovirus is the predominant viral specie; its prevalence is highest in patients with a CD4 lymphocyte count below 200 cells/microL.