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Emerg Infect Dis. Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009?2011
[Source: Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]
Volume 19, Number 11?November 2013
Research
Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009?2011
Cheryl Cohen, Jocelyn Moyes, Stefano Tempia, Michelle Groom, Sibongile Walaza, Marthi Pretorius, Halima Dawood, Meera Chhagan, Summaya Haffejee, Ebrahim Variava, Kathleen Kahn, Akhona Tshangela, Anne von Gottberg, Nicole Wolter, Adam L. Cohen, Babatyi Kgokong, Marietjie Venter, and Shabir A. Madhi
Author affiliations: National Health Laboratory Service, Johannesburg, South Africa (C. Cohen, J. Moyes, S. Walaza, M. Pretorius, A. Tshangela, A. von Gottberg, N. Wolter, B. Kgokong, M. Venter, S.A. Madhi); University of the Witwatersrand, Johannesburg (C. Cohen, J. Moyes, M. Groom, E. Variava, K. Kahn, A. von Gottberg, N. Wolter, S. A. Madhi); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Tempia, A.L. Cohen); Centers for Disease Control and Prevention?South Africa, Pretoria, South Africa (S. Tempia, A. L. Cohen); University of KwaZulu-Natal, Durban, South Africa (H. Dawood, M. Chhagan, S. Haffejee); Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa (H. Dawood); Klerksdorp Tshepong Hospital, Klerksdorp, South Africa (E. Variava); Ume? University, Ume?, Sweden (K. Kahn); INDEPTH Network, Accra, Ghana (K. Kahn); University of Pretoria, Pretoria (M. Venter)
Abstract
Data on influenza epidemiology in HIV-infected persons are limited, particularly for sub-Saharan Africa, where HIV infection is widespread. We tested respiratory and blood samples from patients with acute lower respiratory tract infections hospitalized in South Africa during 2009?2011 for viral and pneumococcal infections. Influenza was identified in 9% (1,056/11,925) of patients enrolled; among influenza case-patients, 358 (44%) of the 819 who were tested were infected with HIV. Influenza-associated acute lower respiratory tract infection incidence was 4?8 times greater for HIV-infected (186?228/100,000) than for HIV-uninfected persons (26?54/100,000). Furthermore, multivariable analysis showed HIV-infected patients were more likely to have pneumococcal co-infection; to be infected with influenza type B compared with type A; to be hospitalized for 2?7 days or >7 days; and to die from their illness. These findings indicate that HIV-infected persons are at greater risk for severe illnesses related to influenza and thus should be prioritized for influenza vaccination.
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Volume 19, Number 11?November 2013
Research
Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009?2011
Cheryl Cohen, Jocelyn Moyes, Stefano Tempia, Michelle Groom, Sibongile Walaza, Marthi Pretorius, Halima Dawood, Meera Chhagan, Summaya Haffejee, Ebrahim Variava, Kathleen Kahn, Akhona Tshangela, Anne von Gottberg, Nicole Wolter, Adam L. Cohen, Babatyi Kgokong, Marietjie Venter, and Shabir A. Madhi
Author affiliations: National Health Laboratory Service, Johannesburg, South Africa (C. Cohen, J. Moyes, S. Walaza, M. Pretorius, A. Tshangela, A. von Gottberg, N. Wolter, B. Kgokong, M. Venter, S.A. Madhi); University of the Witwatersrand, Johannesburg (C. Cohen, J. Moyes, M. Groom, E. Variava, K. Kahn, A. von Gottberg, N. Wolter, S. A. Madhi); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Tempia, A.L. Cohen); Centers for Disease Control and Prevention?South Africa, Pretoria, South Africa (S. Tempia, A. L. Cohen); University of KwaZulu-Natal, Durban, South Africa (H. Dawood, M. Chhagan, S. Haffejee); Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa (H. Dawood); Klerksdorp Tshepong Hospital, Klerksdorp, South Africa (E. Variava); Ume? University, Ume?, Sweden (K. Kahn); INDEPTH Network, Accra, Ghana (K. Kahn); University of Pretoria, Pretoria (M. Venter)
Abstract
Data on influenza epidemiology in HIV-infected persons are limited, particularly for sub-Saharan Africa, where HIV infection is widespread. We tested respiratory and blood samples from patients with acute lower respiratory tract infections hospitalized in South Africa during 2009?2011 for viral and pneumococcal infections. Influenza was identified in 9% (1,056/11,925) of patients enrolled; among influenza case-patients, 358 (44%) of the 819 who were tested were infected with HIV. Influenza-associated acute lower respiratory tract infection incidence was 4?8 times greater for HIV-infected (186?228/100,000) than for HIV-uninfected persons (26?54/100,000). Furthermore, multivariable analysis showed HIV-infected patients were more likely to have pneumococcal co-infection; to be infected with influenza type B compared with type A; to be hospitalized for 2?7 days or >7 days; and to die from their illness. These findings indicate that HIV-infected persons are at greater risk for severe illnesses related to influenza and thus should be prioritized for influenza vaccination.
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