Laura Miller, MPH; Lola Arakaki, MPH; Arianne Ramautar, MPH; Sara Bodach, MPH; Sarah L. Braunstein, PhD, MPH; Joseph Kennedy, MPH; Linda Steiner-Sichel, RN, MPH; Stephanie Ngai, BA; Colin Shepard, MD; Don Weiss, MD, MPH
Acknowledgment: The authors thank Mike Antwi, Beth Begier, Blayne Cutler, Paula Del Rosso, Marie Dorsinville, James Hadler, Marcelle Layton, and Jay Varma.
Grant Support: By the New York City Tax Levy, the Epidemiology and Laboratory Capacity for Infectious Diseases grant of the CDC (ELC ARRA 317-MCV and 3U50C1223667-05S2), and CDC HIV Epidemiology and Field Services Program cooperative agreements (PS08-80202, no. U62/CCU223595, and PS13-1302, no. 1U62PS003993-01).
Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1593.
Reproducible Research Statement: Study protocol and statistical code: Available from Dr. Weiss (e-mail, firstname.lastname@example.org). Data set: Not available.
Requests for Single Reprints: Don Weiss, MD, MPH, New York City Department of Health and Mental Hygiene, Gotham Center, CN#22a, 42-09 28th Street, 6th Floor, Queens, NY 11101-4132; e-mail, email@example.com.
This article was published online first at www.annals.org on 29 October 2013.
Current Author Addresses: Ms. Miller; Ms. Arakaki; Ms. Ramautar; Ms. Bodach; Mr. Kennedy; Ms. Steiner-Sichel; Ms. Ngai; and Drs. Braunstein, Shepard, and Weiss: New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101-4132.
Author Contributions: Conception and design: L. Miller, S. Bodach, S.L. Braunstein, J. Kennedy, L. Steiner-Sichel, C. Shepard, D. Weiss.
Analysis and interpretation of the data: L. Miller, L. Arakaki, S. Bodach, S.L. Braunstein, S. Ngai, D. Weiss.
Drafting of the article: L. Miller, L. Arakaki, A. Ramautar, D. Weiss.
Critical revision of the article for important intellectual content: L. Miller, L. Arakaki, A. Ramautar, S. Bodach, S.L. Braunstein, J. Kennedy, L. Steiner-Sichel, S. Ngai, C. Shepard, D. Weiss.
Final approval of the article: L. Miller, L. Arakaki, A. Ramautar, S. Bodach, S.L. Braunstein, J. Kennedy, L. Steiner-Sichel, S. Ngai, C. Shepard, D. Weiss.
Statistical expertise: L. Arakaki, S. Bodach, S.L. Braunstein, S, Ngai, C. Shepard, D. Weiss.
Obtaining of funding: C. Shepard, D. Weiss.
Administrative, technical, or logistic support: L. Arakaki, A. Ramautar, S. Bodach, J. Kennedy, L. Steiner-Sichel, D. Weiss.
Collection and assembly of data: L. Miller, L. Arakaki, A. Ramautar, S. Bodach, S.L. Braunstein, J. Kennedy, L. Steiner-Sichel, D. Weiss.
Miller L, Arakaki L, Ramautar A, Bodach S, Braunstein SL, Kennedy J, et al. Elevated Risk for Invasive Meningococcal Disease Among Persons With HIV. Ann Intern Med. 2014;160:30-37. doi: 10.7326/0003-4819-160-1-201401070-00731
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Published: Ann Intern Med. 2014;160(1):30-37.
An association between HIV and invasive meningococcal disease (IMD) has been suggested by several previous studies but has not been fully described in the era of highly active antiretroviral therapy in the United States.
To estimate the risk for IMD and death in people living with HIV/AIDS (PLWHA) in New York City (NYC) and the contribution of CD4+ cell count and viral load (VL) to IMD risk.
Comparison of the incidence rate of IMD among PLWHA with that among HIV-uninfected persons. Surveillance data on IMD for patients aged 15 to 64 years from 2000 to 2011 were matched to death and HIV registries to calculate IMD risk and case-fatality ratios. A subset of PLWHA who had a CD4+ cell count and VL measurement near the time of their IMD infection was included in age-matched case–control analyses to assess HIV markers and IMD risk.
Retrospective cohort from communicable disease surveillance.
265 persons aged 15 to 64 years with IMD during 2000 to 2011.
Meningococcal and HIV data abstracted from surveillance and registry databases, including CD4+ cell counts and VL.
The average annual incidence rate of IMD was 0.39 cases per 100 000 persons. The relative risk for IMD among PLWHA in NYC during 2000 to 2011 was 10.0 (95% CI, 7.2 to 14.1). Among PLWHA, patients with IMD were 5.3 times (CI, 1.4 to 20.4 times) as likely as age-matched control patients to have CD4+ counts less than 0.200 × 109 cells/L.
Missing data on smoking status and comorbidity.
People living with HIV/AIDS in NYC are at increased risk for IMD. Cost-effectiveness and vaccine efficacy studies are needed to evaluate the value of a national recommendation for routine meningococcal vaccination of PLWHA.
New York City Tax Levy.
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