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.
