Incidence and risk factors of fever in a contemporary cohort of HIV-patients with good access to antiretroviral therapy

Abstract

Objective: To study incidence and to determine risk factors of fever in a contemporary cohort of HIV-infected patients with access to antiretroviral therapy.

Methods: Prospective study in a cohort of HIV-infected patients in Belgium from 2009 to 2013.

Results: 759 patients were followed for a total of 2136 patient years. The incidence of fever was low, with an incidence rate of 0.103 (95% CI 0.078; 0.135) febrile episodes per patient per year for temperature 38.3 °C or higher measured by a health care provider. Gender, age, ethnicity, and calendar year of measurement were no significant risk factors for fever in univariable analysis, but recent HIV diagnosis, prior AIDS, nadir CD4 cell count, last CD4 cell count, and viral load were, as were use of antiretroviral therapy, recent start of antiretroviral therapy and recent switch of antiretroviral therapy. Recent stop of antiretroviral therapy was no significant risk factor. In multivariable analysis prior AIDS, last CD4 and viral load remained significant risk factors, but use of antiretroviral therapy not.

Conclusion: In this contemporary cohort, incidence of fever was low but CD4 cell count less than 200/mm³ remained associated with the highest incidence of fever.

Keywords:

• Fever
• HIV
• Incidence
• HIV-associated FUO
• Risk factors

Acknowledgments

We thank all the patients participating in the study, the clinical trial assistants, Mrs H. Ceunen and Miss A. Gerits, for logistic assistance and data entry and the residents of the internal medicine department of UZ Leuven for filling out the forms during the consultations.