Leptospirosis and human immunodeficiency virus co-infection among febrile inpatients in northern Tanzania.

dc.contributor.author

Biggs, Holly M

dc.contributor.author

Galloway, Renee L

dc.contributor.author

Bui, Duy M

dc.contributor.author

Morrissey, Annie B

dc.contributor.author

Maro, Venance P

dc.contributor.author

Crump, John A

dc.coverage.spatial

United States

dc.date.accessioned

2017-03-02T19:13:56Z

dc.date.available

2017-03-02T19:13:56Z

dc.date.issued

2013-08

dc.description.abstract

BACKGROUND: Leptospirosis and human immunodeficiency virus (HIV) infection are prevalent in many areas, including northern Tanzania, yet little is known about their interaction. METHODS: We enrolled febrile inpatients at two hospitals in Moshi, Tanzania, over 1 year and performed HIV antibody testing and the microscopic agglutination test (MAT) for leptospirosis. Confirmed leptospirosis was defined as ≥ four-fold rise in MAT titer between acute and convalescent serum samples, and probable leptospirosis was defined as any reciprocal MAT titer ≥ 800. RESULTS: Confirmed or probable leptospirosis was found in 70 (8.4%) of 831 participants with at least one serum sample tested. At total of 823 (99.0%) of 831 participants had HIV testing performed, and 203 (24.7%) were HIV infected. Among HIV-infected participants, 9 (4.4%) of 203 had confirmed or probable leptospirosis, whereas among HIV-uninfected participants 61 (9.8%) of 620 had leptospirosis. Leptospirosis was less prevalent among HIV-infected as compared to HIV-uninfected participants [odds ratio (OR) 0.43, p=0.019]. Among those with leptospirosis, HIV-infected patients more commonly presented with features of severe sepsis syndrome than HIV-uninfected patients, but differences were not statistically significant. Among HIV-infected patients, severe immunosuppression was not significantly different between those with and without leptospirosis (p=0.476). Among HIV-infected adolescents and adults, median CD4 percent and median CD4 count were higher among those with leptospirosis as compared to those with other etiologies of febrile illness, but differences in CD4 count did not reach statistical significance (p=0.015 and p=0.089, respectively). CONCLUSIONS: Among febrile inpatients in northern Tanzania, leptospirosis was not more prevalent among HIV-infected patients. Although some indicators of leptospirosis severity were more common among HIV-infected patients, a statistically significant difference was not demonstrated. Among HIV-infected patients, those with leptospirosis were not more immunosuppressed relative to those with other etiologies of febrile illness.

dc.identifier

https://www.ncbi.nlm.nih.gov/pubmed/23663165

dc.identifier.eissn

1557-7759

dc.identifier.uri

https://hdl.handle.net/10161/13780

dc.language

eng

dc.publisher

Mary Ann Liebert Inc

dc.relation.ispartof

Vector Borne Zoonotic Dis

dc.relation.isversionof

10.1089/vbz.2012.1205

dc.subject

Adolescent

dc.subject

Adult

dc.subject

Aged

dc.subject

Animals

dc.subject

Antibodies, Bacterial

dc.subject

Antibodies, Viral

dc.subject

Child

dc.subject

Child, Preschool

dc.subject

Coinfection

dc.subject

Female

dc.subject

Fever

dc.subject

HIV Infections

dc.subject

HIV-1

dc.subject

HIV-2

dc.subject

Humans

dc.subject

Infant

dc.subject

Inpatients

dc.subject

Leptospira

dc.subject

Leptospirosis

dc.subject

Male

dc.subject

Middle Aged

dc.subject

Tanzania

dc.subject

Young Adult

dc.title

Leptospirosis and human immunodeficiency virus co-infection among febrile inpatients in northern Tanzania.

dc.type

Journal article

pubs.author-url

https://www.ncbi.nlm.nih.gov/pubmed/23663165

pubs.begin-page

572

pubs.end-page

580

pubs.issue

8

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Duke

pubs.organisational-group

Medicine

pubs.organisational-group

Medicine, Infectious Diseases

pubs.organisational-group

Pathology

pubs.organisational-group

School of Medicine

pubs.publication-status

Published

pubs.volume

13

Files

Original bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
VectorBorneZoonoticDis_LeptoHIV.pdf
Size:
283.11 KB
Format:
Adobe Portable Document Format