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Excess Mortality Due to Pneumonia or Influenza During Influenza Seasons Among Persons With Acquired Immunodeficiency Syndrome
Joseph C. Lin, MD;
Kristin L. Nichol, MD, MPH
Arch Intern Med. 2001;161:441-446.
Background Anecdotal reports suggest that influenza-related morbidity may be high
among persons with acquired immunodeficiency syndrome (AIDS), but little information
is available concerning the population-level impact of influenza on mortality
in persons with AIDS.
Methods Using the Multiple Cause-of-Death data files, which contain information
on all deaths occurring in the United States each year, we calculated the
numbers of excess deaths and rates of excess death due to pneumonia or influenza
among persons with AIDS aged 13 years and older during the influenza seasons
1991-1992 through 1993-1994. For comparison, numbers of excess deaths and
excess death rates were also calculated for several other groups including
the general US population aged 13 years and older and the general US population
aged 65 years and older.
Results During the 1991-1992, 1992-1993, and 1993-1994 influenza seasons, there
were 261, 254, and 191 excess deaths due to pneumonia or influenza in persons
with AIDS and excess death rates of 19.74, 15.38, and 10.17 deaths per 10 000
persons, respectively, compared with a summer baseline period. For the same
seasons, we observed excess death rates of 1.40, 1.62, and 1.48 for the general
US population aged 13 years and older and 8.10, 9.28, and 8.54 for the general
US population aged 65 years and older. Thus, persons with AIDS had excess
death rates substantially higher than the general US population and similar
to, if not somewhat higher than, the general US population aged 65 years and
older, a group that is already targeted for annual vaccination. The findings
were similar when we compared the preinfluenza season with the influenza season.
Conclusions Persons with AIDS have significant excess mortality due to pneumonia
or influenza during influenza seasons and should be considered a high-risk
group that is targeted for the prevention of influenza.
From the Medicine Service and Center for Chronic Disease Outcomes Research,
Veterans Affairs Medical Center and the Department of Medicine, University
of Minnesota Medical School, Minneapolis.
Corresponding author and reprints: Kristin L. Nichol, MD, MPH, Medicine
Service, Veterans Affairs Medical Center (111), 1 Veterans Dr, Minneapolis,
MN 55417 (e-mail: nicho014{at}tc.umn.edu).
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