Invasive pneumococcal diseases remain frequent and severe in HIV-infected subjects. To identify opportunities for prevention, we assessed risk factors of invasive pneumococcal diseases in HIV-infected patients over a 10-year period in France.

We performed a retrospective case-control study in a reference center of HIV management in Paris. All HIV-infected patients having suffered from invasive pneumococcal diseases between 2000 and 2011 were included. Control subjects were HIV-infected with no history of invasive pneumococcal diseases or pneumonia, matched by date of diagnosis of HIV with controls. Two controls were randomly selected for each subject.

In all, 42 HIV-infected patients presented 44 invasive pneumococcal diseases during the study period and were compared to 84 controls. In the multivariate analysis, patients with invasive pneumococcal diseases were more likely than controls to have a Charlson Comorbidity Index ≥2 (adjusted OR = 7.07, 95% CI 1.99–25.1, p = 0.003), CD4-cell count <200/cells/µL (aOR = 6.93, 95% CI 1.80–26.7, p = 0.005), HIV-RNA viral load >400 copies/mL (aOR = 5.56, 95% CI 1.58–19.5, p = 0.007) and a non-European origin (aOR = 4.26, 95% CI 1.02–17.9, p = 0.047).

HIV-infected patients with a higher burden of comorbidities, uncontrolled HIV replication, low CD4-cell counts and/or of non-European origin are at higher risk of developing IPD. Better screening for and management of HIV infection is necessary to reduce the risk of IPD.