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J Infect Dis. 2018 May 24. doi: 10.1093/infdis/jiy310. [Epub ahead of print]
Influenza viral shedding in a prospective cohort of HIV-infected and -uninfected children and adults in 2 provinces of South Africa, 2012-2014.
von Mollendorf C1,2, Hellferscee O1,3, Valley-Omar Z1,4, Treurnicht FK1, Walaza S1,2, Martinson NA5, Lebina L5, Mothlaoleng K5, Mahlase G6, Variava E7,8, Cohen AL9,10, Venter M11, Cohen C1,2, Tempia S9,10.
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Abstract
Background:
Prolonged shedding of influenza viruses may be associated with increased transmissibility and resistance mutation acquisition due to therapy. We compared duration and magnitude of influenza shedding between HIV-infected and -uninfected individuals.
Methods:
A prospective cohort study during three influenza seasons enrolled patients with influenza-like illness and a positive influenza rapid test. Influenza viruses were detected by real-time reverse transcription polymerase chain reaction. Weibull accelerated failure time regression models were used to describe influenza virus shedding. Mann-Whitney U tests explored initial influenza viral loads (VL).
Results:
Influenza virus shedding duration was similar in 65 HIV-infected (6 [interquartile range (IQR) 3-10] days) and 176 HIV-uninfected individuals (7 [IQR 4-11] days, p=0.97), as was initial influenza VL (HIV-uninfected 5.28 +/- 1.33 log10 copies/mL, HIV-infected 4.73 +/- 1.68 log10 copies/mL, p=0.08). Adjusted for age, HIV-infected individuals with low CD4 counts shed influenza virus for longer than those with higher counts (adjusted hazard ratio [aHR] 3.55, 95% confidence interval [CI] 1.05-12.08).
Discussion:
A longer duration of influenza virus shedding in HIV-infected individuals with low CD4 counts may suggest a possible increased risk for transmission or viral evolution in severely immunocompromised individuals. HIV-infected individuals should be prioritized for annual influenza immunization.
PMID: 29800425 DOI: 10.1093/infdis/jiy310
Influenza viral shedding in a prospective cohort of HIV-infected and -uninfected children and adults in 2 provinces of South Africa, 2012-2014.
von Mollendorf C1,2, Hellferscee O1,3, Valley-Omar Z1,4, Treurnicht FK1, Walaza S1,2, Martinson NA5, Lebina L5, Mothlaoleng K5, Mahlase G6, Variava E7,8, Cohen AL9,10, Venter M11, Cohen C1,2, Tempia S9,10.
Author information
Abstract
Background:
Prolonged shedding of influenza viruses may be associated with increased transmissibility and resistance mutation acquisition due to therapy. We compared duration and magnitude of influenza shedding between HIV-infected and -uninfected individuals.
Methods:
A prospective cohort study during three influenza seasons enrolled patients with influenza-like illness and a positive influenza rapid test. Influenza viruses were detected by real-time reverse transcription polymerase chain reaction. Weibull accelerated failure time regression models were used to describe influenza virus shedding. Mann-Whitney U tests explored initial influenza viral loads (VL).
Results:
Influenza virus shedding duration was similar in 65 HIV-infected (6 [interquartile range (IQR) 3-10] days) and 176 HIV-uninfected individuals (7 [IQR 4-11] days, p=0.97), as was initial influenza VL (HIV-uninfected 5.28 +/- 1.33 log10 copies/mL, HIV-infected 4.73 +/- 1.68 log10 copies/mL, p=0.08). Adjusted for age, HIV-infected individuals with low CD4 counts shed influenza virus for longer than those with higher counts (adjusted hazard ratio [aHR] 3.55, 95% confidence interval [CI] 1.05-12.08).
Discussion:
A longer duration of influenza virus shedding in HIV-infected individuals with low CD4 counts may suggest a possible increased risk for transmission or viral evolution in severely immunocompromised individuals. HIV-infected individuals should be prioritized for annual influenza immunization.
PMID: 29800425 DOI: 10.1093/infdis/jiy310