tetano
Editor, Senior Moderator
J Infect Dis. 2018 May 24. doi: 10.1093/infdis/jiy310. [Epub ahead of print]
[h=1]Influenza viral shedding in a prospective cohort of HIV-infected and -uninfected children and adults in 2 provinces of South Africa, 2012-2014.[/h] von Mollendorf C[SUP]1,[/SUP][SUP]2[/SUP], Hellferscee O[SUP]1,[/SUP][SUP]3[/SUP], Valley-Omar Z[SUP]1,[/SUP][SUP]4[/SUP], Treurnicht FK[SUP]1[/SUP], Walaza S[SUP]1,[/SUP][SUP]2[/SUP], Martinson NA[SUP]5[/SUP], Lebina L[SUP]5[/SUP], Mothlaoleng K[SUP]5[/SUP], Mahlase G[SUP]6[/SUP], Variava E[SUP]7,[/SUP][SUP]8[/SUP], Cohen AL[SUP]9,[/SUP][SUP]10[/SUP], Venter M[SUP]11[/SUP], Cohen C[SUP]1,[/SUP][SUP]2[/SUP], Tempia S[SUP]9,[/SUP][SUP]10[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] 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.
[h=4]Methods:[/h] 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).
[h=4]Results:[/h] 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).
[h=4]Discussion:[/h] 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
[h=1]Influenza viral shedding in a prospective cohort of HIV-infected and -uninfected children and adults in 2 provinces of South Africa, 2012-2014.[/h] von Mollendorf C[SUP]1,[/SUP][SUP]2[/SUP], Hellferscee O[SUP]1,[/SUP][SUP]3[/SUP], Valley-Omar Z[SUP]1,[/SUP][SUP]4[/SUP], Treurnicht FK[SUP]1[/SUP], Walaza S[SUP]1,[/SUP][SUP]2[/SUP], Martinson NA[SUP]5[/SUP], Lebina L[SUP]5[/SUP], Mothlaoleng K[SUP]5[/SUP], Mahlase G[SUP]6[/SUP], Variava E[SUP]7,[/SUP][SUP]8[/SUP], Cohen AL[SUP]9,[/SUP][SUP]10[/SUP], Venter M[SUP]11[/SUP], Cohen C[SUP]1,[/SUP][SUP]2[/SUP], Tempia S[SUP]9,[/SUP][SUP]10[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] 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.
[h=4]Methods:[/h] 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).
[h=4]Results:[/h] 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).
[h=4]Discussion:[/h] 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