Camon S, et al. - The researchers aimed to evaluate the predictive value of analytical markers of full blood count that can be assessed in the Emergency Department for HIV infected patients, with community-acquired pneumonia (CAP). They recognized red blood cell distribution and lymphocytes to be the most useful predictors of disease severity identifying HIV infected patients with CAP who required intensive care unit (ICU) admission.

Methods

• Researchers undertook a prospective 3-year study including all HIV-infected patients that went to the Emergency Department with respiratory clinical infection, more than 24-h earlier they were diagnosed with CAP and required admission.
• The different values of the first blood count performed on the patient were assessed as follows; total white blood cells (WBC), neutrophils, lymphocytes (LYM), basophils, eosinophils (EOS), red blood cells (RBC), hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, red blood cell distribution width (RDW), platelets (PLT), mean platelet volume, and platelet distribution width (PDW).
• Thirty-day mortality was included as the primary outcome measure.
• The secondary outcome measure included admission to an intensive care unit (ICU).
• Using statistical calculation, the predictive power of the variables was determined.

Results

• Researchers identified 160 HIV-infected patients with pneumonia; mean age was 42 (11) years; 99 (62%) were male;79 (49%) had ART.
• Parenteral administration of drugs was noted to be the main route of HIV transmission.
• The most frequently identified etiologic agent of CAP was Streptococcus pneumonia.
• The univariate analysis suggested the values of PLT (p < 0.009), EOS (p < 0.033), RDW (p < 0.033) and PDW (p < 0.09) to be predictor of mortality; however, no variable was shown as an independent predictor of mortality after the logistic regression analysis.
• On the other hand, higher RDW (OR = 1.2, 95% CI 1.1-1.4, p=0.013) and a lower number of LYM (OR 2.2, 95% CI 1.1-2.2; p=0.035) were noted to be independent predictors of admission to ICU.