Severe influenza-associated respiratory infection in high HIV prevalence setting, South Africa, 2009-2011

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Authors

Cohen, Cheryl
Moyes, Jocelyn
Tempia, Stefano
Groome, Michelle
Walaza, Sibongile
Pretorius, Marthi Andréa
Dawood, Halima
Chhagan, Meera
Haffejee, Summaya
Variava, Ebrahim

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Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention

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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Keywords

Respiratory infection, HIV, South Africa, Patients

Sustainable Development Goals

Citation

Cohen, C, Moyes, J, Tempia, S, Groom, M, Walaza, S, Pretorius, M, Dawood, H, Chhagan, M, Haffejee, S, Variava, E, Kahn, K, Tshangela, A, Von Gottberg, A, Wolter, N, Cohen, AL, Kgokong, B, Venter, M & Madhi, SA 2013 , 'Severe influenza-associated respiratory infection in high HIV prevalence setting, South Africa, 2009-2011', Emerging Infectious Diseases, vol. 19, no. 11, pp. 1766-1774.