Severity of respiratory syncytial virus lower respiratory tract infection with viral coinfection in HIV-uninfected children
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Date
Authors
Mazur, Natalie I.
Bont, Louis
Cohen, Adam L.
Cohen, Cheryl
Von Gottberg, Anne
Groome, Michelle J.
Hellferscee, Orienka
Klipstein-Grobusch, Kerstin
Mekgoe, Omphile Tschegofatso
Naby, Fathima
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press
Abstract
BACKGROUND : Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. METHODS : Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009–December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death. RESULTS : Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)–associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease (odds ratio [OR], 1.4; 95% confidence interval [CI], OR, 0.74; 95% CI, .39–1.4), ADV coinfection had increased odds of life-threatening disease (adjusted OR,
3.4; 95% CI, 1.6–7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay
(adjusted OR, 2.1; 95% CI, 1.0–4.5; P = .05) compared with RSV monoinfection.
CONCLUSIONS : RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV
alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study
Description
Keywords
Respiratory syncytial virus (RSV), Viral coinfection, Lower respiratory tract infection (LRTI)
Sustainable Development Goals
Citation
Mazur, NI, Bont, L, Cohen, AL, Cohen, C, Von Gottberg, A, Groome, MJ, Hellferscee, O, Klipstein-Grobusch, K, Mekgoe, O, Naby, F, Moyes, J, Tempia, S, Treurnicht, FK, Venter, M, Walaza, S, Wolter, N & Madhi, SA 2017, 'Severity of respiratory syncytial virus lower respiratory tract infection with viral coinfection in HIV-uninfected children', Clinical Infectious Diseases, vol. 64, no. 4, pp. 443-450.