Table 3. Comparison of HIV-infected and HIV-uninfected patients (5-years and older) with invasive pneumococcal disease, South Africa, 2003–2008 (n = 4 734).
| HIV-infected | HIV-uninfected | Univariate analysis | Multivariable analysis | |||||
|---|---|---|---|---|---|---|---|---|
| n | % | n | % | Odds Ratio (95% confidence interval) | P-value | Odds Ratio (95% confidence interval) | P-value | |
| Total cases | 4 190 | 89 | 544 | 12 | ||||
| Age category (n = 4 734) | ||||||||
| 5–19 years | 567 | 14 | 140 | 26 | Reference | <0.001 | Reference | <0.001 |
| 20–49 years | 3 271 | 78 | 274 | 50 | 3 (2.4–3.7) | 2.9 (2.2–3.9) | ||
| 50–64 years | 313 | 8 | 85 | 16 | 0.9 (0.7–1.2) | 0.8 (0.6–1.2) | ||
| ≥65 years | 39 | 1 | 45 | 8 | 0.2 (0.1–0.3) | 0.3 (0.1–0.5) | ||
| Sex (n = 4 729) | ||||||||
| Female | 2 337 | 56 | 224 | 41 | 1.8 (1.5–2.2) | <0.001 | 1.5 (1.2–1.9) | <0.001 |
| Specimen type (n = 4 734) | ||||||||
| Cerebrospinal Fluid | 875 | 21 | 112 | 21 | Reference | 0.013 | ||
| Blood | 3 091 | 74 | 386 | 71 | 1 (0.8–1.3) | |||
| Other | 224 | 5 | 46 | 9 | 0.6 (0.4–0.9) | |||
| Clinical syndrome (n = 4 711) | ||||||||
| Meningitis | 1 112 | 27 | 148 | 27 | Reference | <0.001 | Reference | <0.001 |
| Bacteremic pneumonia | 2 653 | 64 | 294 | 54 | 1.2 (1–1.5) | 1.3 (1–1.7) | ||
| Bacteremia without focus | 170 | 4 | 47 | 9 | 0.5 (0.3–0.7) | 0.5 (0.3–0.8) | ||
| Other | 235 | 6 | 52 | 10 | 0.6 (0.4–0.9) | 0.6 (0.4–0.9) | ||
| Severity of illness (Pitt bacteremia score) (n = 4 155) | ||||||||
| 0 | 1 490 | 41 | 214 | 45 | Reference | Reference | 0.1 | |
| 1–3 | 1 815 | 49 | 200 | 42 | 1.3 (1.1–1.6) | 0.009 | 1.2 (0.9–1.6) | |
| 4–12 | 375 | 10 | 61 | 13 | 0.9 (0.7–1.2) | 0.8 (0.5–1.2) | ||
| Predisposing condition (n = 4 734) | ||||||||
| Yes | 790 | 19 | 210 | 39 | 0.4 (0.3–0.4) | <0.001 | 0.4 (0.3–0.5) | <0.001 |
| Predisposing condition specified | ||||||||
| - ACIP condition# | 770 | 97 | 206 | 98 | Reference | 0.599 | ||
| - Other risk factor | 20 | 3 | 4 | 2 | 1.3 (0.5–4) | |||
| Recurrences of IPD (n = 4 734) | ||||||||
| Yes | 224 | 5 | 36 | 7 | 0.1 (0.6–1.2) | 0.221 | ||
| Outcome (n = 4 710) | ||||||||
| Died in hospital | 1 138 | 27 | 107 | 20 | 1.9 (1.4–2.5) | <0.001 | 2 (1.4–2.7) | <0.001 |
| Antimicrobial susceptibility (n = 3 639) | 3 205 | 434 | ||||||
| Penicillin^ | ||||||||
| Non-susceptible | 926 | 29 | 84 | 19 | 1.7 (1.3–2.2) | <0.001 | ||
| Erythromycin | ||||||||
| Non-susceptible | 359 | 11 | 37 | 9 | 1.4 (1–1.9) | 0.093 | ||
| Cotrimoxazole | ||||||||
| Non-susceptible | 1 653 | 52 | 157 | 36 | 1.9 (1.5–2.3) | <0.001 | 1.9 (1.5–2.4) | <0.001 |
| 3rd Generation Cephalosporin | ||||||||
| Non-susceptible | 20 | 1 | 2 | 1 | 1.4 (0.3–5.8) | 0.681 | ||
| Serotypes (n = 3 639) | 3205 | 434 | ||||||
| PCV13* | ||||||||
| Vaccine types | 2272 | 71 | 317 | 73 | 0.9 (0.7–1.1) | 0.353 | ||
| PPV23** | ||||||||
| Vaccine types | 2685 | 84 | 372 | 86 | 0.9 (0.6–1.1) | 0.301 | ||
Footnote:
#ACIP (Advisory Committee on Immunization Practices) condition includes: asplenia; sickle cell anaemia; chronic lung, renal, liver or cardiac disease; diabetes; solid organ transplant; primary immunodeficiency syndromes; immunomodulation therapy; malignancies; head injuries with CSF leak; alcohol dependency and smoking.
^Penicillin non-susceptibility was associated with cotrimoxazole non-susceptibility thus it was not included in the final multivariate model.
*PCV13 (Pneumococcal Conjugate Vaccine-13 valent) serotypes include: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 23F.
**PPV23 (Pneumococcal Polysaccharide Vaccine-23 valent) serotypes include: 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19A, 19F, 20, 22F, 23F, 33F,(6A cross protection is assumed).