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The role of HIV in influenza- and respiratory syncytial virus-associated hospitalizations in South African children, 2011-2016

tetano

Editor, Senior Moderator
Clin Infect Dis. 2018 Jun 29. doi: 10.1093/cid/ciy532. [Epub ahead of print]
[h=1]The role of HIV in influenza- and respiratory syncytial virus-associated hospitalizations in South African children, 2011-2016.[/h] McMorrow ML[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Tempia S[SUP]1,[/SUP][SUP]2,[/SUP][SUP]4[/SUP], Walaza S[SUP]4,[/SUP][SUP]5[/SUP], Treurnicht FK[SUP]4[/SUP], Moyes J[SUP]4,[/SUP][SUP]5[/SUP], Cohen AL[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3,[/SUP][SUP]6[/SUP], Pretorius M[SUP]4,[/SUP][SUP]7[/SUP], Hellferscee O[SUP]4,[/SUP][SUP]8[/SUP], Wolter N[SUP]4,[/SUP][SUP]8[/SUP], von Gottberg A[SUP]4,[/SUP][SUP]8[/SUP], Nguweneza A[SUP]4[/SUP], McAnerney JM[SUP]4[/SUP], Naby F[SUP]9[/SUP], Mekgoe O[SUP]10[/SUP], Venter M[SUP]11[/SUP], Madhi SA[SUP]12,[/SUP][SUP]13[/SUP], Cohen C[SUP]4,[/SUP][SUP]5[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Background:[/h] Few data describe influenza- or respiratory syncytial virus (RSV)-associated hospitalized illness in children aged <5 years in sub-Saharan Africa.
[h=4]Methods:[/h] During 2011-2016, we conducted prospective surveillance for severe respiratory illness (SRI) in children aged <5 years in three South African hospitals. Nasopharyngeal aspirates were tested for influenza and RSV by real-time reverse transcription polymerase chain reaction. We estimated rates of influenza- and RSV-associated hospitalized SRI by HIV status and compared children who tested positive for influenza versus RSV using multivariable penalized logistic regression.
[h=4]Results:[/h] Among 3650 hospitalized children, 203 (5.6%) tested positive for influenza viruses, 874 (23.9%) for RSV, and 19 (0.5%) for both. The median age of children hospitalized with influenza was 13.9 months versus 4.4 months for RSV (p<0.01). Annual influenza-associated hospitalization rates per 100,000 were highest among infants aged 6-11 months (545, 95% Confidence Interval (CI): 409-703), while RSV-associated hospitalization rates were highest in infants aged 0-2 months (6593, 95% CI: 5947-7217). HIV exposure was associated with increased incidence of influenza- and RSV-associated hospitalization in infants aged 0-5 months, Relative Risk (RR) 2.2 (95% CI: 1.4-3.4) and 1.4 (95% CI: 1.3-1.6), respectively. HIV infection was associated with increased incidence of influenza- and RSV-associated hospitalization in all age groups; RR 2.7 (95% CI: 2.0-3.5) and 3.8 (95% CI: 3.1-4.8), respectively. The case-fatality rate was 0.8% among children hospitalized with influenza or RSV.
[h=4]Conclusions:[/h] Influenza- and RSV-associated hospitalization are common among South African infants. HIV infection, and HIV exposure in infants, increase risk of influenza- and RSV-associated hospitalization.


PMID: 29961814 DOI: 10.1093/cid/ciy532
 
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