Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study

Objectives Incidence rates (IRs) of Staphylococcus aureus bacteraemia (SAB) are known to be higher in HIV‐infected individuals than in the general population, but have not been assessed in the era of highly active antiretroviral therapy. Methods From 1 January 1995 to 31 December 2007, all Danish HIV‐infected individuals (n=4871) and population controls (n=92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time‐updated Poisson regression analysis. Results We identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5–30.0, for HIV‐infected vs. non‐HIV‐infected individuals]. Over time, IR declined for HIV‐infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV‐infected individuals, a latest CD4 count MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV‐infected individuals.