Abstract

Influenza like illness (ILI) in an AIDS Clinic during Influenza H1N1 outbreak in Brazil

M.I.B.F. Lopes¹, A.T.W. Song¹, S.P. Goulart², C.T.G. Novaes¹, E.B. Gutierrez<sup>1

1</sup>Casa da AIDS - University of São Paulo, Sao Paulo, Brazil, ²Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil

Background: Swine influenza emerged last year on Northern hemisphere but suddenly spread to south countries during winter. The hallmark of this epidemic was the increased number of hospitalizations and deaths especially in particular subsets of patients. HIV infected patients are often classified as a more vulnerable population with increased risk of complication. Here we describe the case presentation and baseline characteristics and outcome of a patients evaluated with ILI during the flu outbreak in São Paulo, Brazil.
Methods: Patients presenting with ILI from a single AIDS Center in São Paulo with about 3300 patients in follow-up. Patients were evaluated through a standardized form. Data about hospitalization was compiled from an institutional database. ILI definition in Brazil is the presence of fever (temperature > 38o.C) and cough or odinophagy.
Results: 119 patients presented with ILI from July to October 2009. This represents 9,7% of total non-scheduled appointments during this period. 56% were male, mean age was 44 years (25-66), CD4 count value was 570 cels/ml (SD = 270). The most frequent symptom besides de defining criteria was mialgia referred by 66,4% of patients, cough was present in 80,4%, and odinophagy in 52.9% of cases. 27,7% of patients have at presentation one or more comorbidites that increase the risk of complications (chronic respiratory diseases in 6,7%). 29,6% have oxygen saturation below 96% but only 1,7% below 90%. 11,8% were referred to emergency unit but only 4,2% were hospitalized with no deaths. Oseltamivir was prescribed to 30.3% of cases. RT-PCR for H1N1 was performed on the first 19 patients and was positive in 47% of those (9patients).
Conclusions: ILI during a Influenza outbreak in our center didn't differ from that observed in non HIV/AIDS patients. Few patients presented with respiratory distress and there are no deaths. Oseltamivir use could have contributed for this result.