Epidemiology and outcome of Clostridium difficile infection and diarrhea in HIV infected inpatients

Clostridium difficile causes diarrhea in HIV infected patients but reports of prevalence, risk factors, and outcome vary. We studied the impact of C. difficile in 161 HIV infected inpatients admitted to Cook County Hospital. Patients with C. difficile had more hospital admissions in the previous 6 months (p = .04), spent more days in the hospital in the previous 3 months (p = .02), more often had previously received H2 blockers or treatment for Pneumocystis carinii (p < .05), and had a more frequent history of herpesvirus (p = .03) or opportunistic infections (p = .04). C. difficile associated diarrhea (CDAD) was the etiology in 32% of all study patients with diarrhea. Patients with CDAD were hospitalized for longer periods (p = .02) and received more antibiotics (p = .002). C. difficile was frequently present in our HIV infected patients, especially those with advanced HIV disease, but appeared to have little impact on morbidity or mortality.