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Duration of Influenza Virus Shedding among HIV-Infected Adults in the cART era, 2010-2011

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  • Duration of Influenza Virus Shedding among HIV-Infected Adults in the cART era, 2010-2011

    AIDS Res Hum Retroviruses. 2016 May 12. [Epub ahead of print]
    Duration of Influenza Virus Shedding among HIV-Infected Adults in the cART era, 2010-2011.

    Patel P1, Bush T2, Kojic EM3, Overton ET4, Henry K5, Onen N6, Rhame F7, Conley L8, Brooks J9, Fry A10.
    Author information

    Abstract

    The duration of influenza virus shedding in HIV-infected adults is unknown and could affect quarantine and treatment recommendations. Participants were monitored for influenza-like illness (ILI), defined as fever and cough or sore throat, using weekly telephone audio computer-assisted self-interviews. Those with ILI were further evaluated at three HIV-specialty clinics. For those with influenza, we collected nasopharyngeal washes every three days after the date of confirmed influenza infection for 21-28 days; specimens underwent RT-PCR and viral culture. Duration of influenza virus shedding was the interval from the date of onset (day 0) of ILI to the date of last culture-positive specimen. Characteristics were compared between patients with and without influenza using Fisher's exact test. We used the Wilcoxon rank-sum test to examine factors that may have affected influenza virus shedding. From 10/2010 to 4/2011, we enrolled 961 participants in syndromic surveillance and diagnosed 20 patients with influenza whose characteristics were: median age 48 years (interquartile range [IQR]: 43-53), 60% male, 50% non-Hispanic black, 95% had been prescribed cART, 85% were virologically suppressed (HIV RNA <400 copies/mL), median CD4 cell count 317 cells/mm3 (IQR: 190-544), and median follow-up time 21 days (IQR: 19-22). Compared with persons without influenza, persons with influenza were more likely to be older, use injection drugs, have a lower median CD4 cell count, and were less likely to have had an influenza vaccination in the past 12 months. Median durations of shedding, PCR detection, and ILI symptoms were 3 (IQR: 0-5), 10 (IQR: 6-15), and 14 days (IQR: 12-26), respectively. Median days of shedding were similar among patients with and without any prior influenza vaccination (0 vs. 4, p=0.448), HIV viral suppression (2 vs. 6, p=0.053), and oseltamivir use (5 vs. 0, p=0.083). HIV-infected persons on cART in our study shed influenza virus for a similar duration as that reported for HIV-uninfected persons.


    PMID: 27174191 [PubMed - as supplied by publisher]
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