Epidemiology of acute lower respiratory tract infection in HIV exposed uninfected infants

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dc.contributor.author Cohen, Cheryl
dc.contributor.author Moyes, Jocelyn
dc.contributor.author Tempia, Stefano
dc.contributor.author Groome, Michelle
dc.contributor.author Walaza, Sibongile
dc.contributor.author Pretorius, Marthi A.
dc.contributor.author Naby, Fathima
dc.contributor.author Mekgoe, Omphile
dc.contributor.author Kahn, Kathleen
dc.contributor.author Von Gottberg, Anne
dc.contributor.author Wolter, Nicole
dc.contributor.author Cohen, Adam L.
dc.contributor.author Von Mollendorf, Claire
dc.contributor.author Venter, Marietjie
dc.contributor.author Madhi, Shabir A.
dc.date.accessioned 2017-06-22T05:55:34Z
dc.date.available 2017-06-22T05:55:34Z
dc.date.issued 2016-04
dc.description.abstract BACKGROUND : Increased morbidity and mortality from lower respiratory tract infection (LRTI) abstract has been suggested in HIV-exposed uninfected (HEU) children; however, the contribution of respiratory viruses is unclear. We studied the epidemiology of LRTI hospitalization in HIVunexposed uninfected (HUU) and HEU infants aged <6 months in South Africa. METHODS : We prospectively enrolled hospitalized infants with LRTI from 4 provinces from 2010 to 2013. Using polymerase chain reaction, nasopharyngeal aspirates were tested for 10 viruses and blood for pneumococcal DNA. Incidence for 2010–2011 was estimated at 1 site with population denominators. RESULTS : We enrolled 3537 children aged <6 months. HIV infection and exposure status were determined for 2507 (71%), of whom 211 (8%) were HIV infected, 850 (34%) were HEU, and 1446 (58%) were HUU. The annual incidence of LRTI was elevated in HEU (incidence rate ratio [IRR] 1.4; 95% confidence interval [CI] 1.3–1.5) and HIV infected (IRR 3.8; 95% CI 3.3–4.5), compared with HUU infants. Relative incidence estimates were greater in HEU than HUU, for respiratory syncytial virus (RSV; IRR 1.4; 95% CI 1.3–1.6) and human metapneumovirus–associated (IRR 1.4; 95% CI 1.1–2.0) LRTI, with a similar trend observed for influenza (IRR 1.2; 95% CI 0.8–1.8). HEU infants overall, and those with RSV-associated LRTI had greater odds (odds ratio 2.1, 95% CI 1.1–3.8, and 12.2, 95% CI 1.7–infinity, respectively) of death than HUU. CONCLUSIONS : HEU infants were more likely to be hospitalized and to die in-hospital than HUU, including specifically due to RSV. This group should be considered a high-risk group for LRTI. en_ZA
dc.description.department Medical Virology en_ZA
dc.description.librarian am2017 en_ZA
dc.description.uri http://pediatrics.aappublications.org en_ZA
dc.identifier.citation Cohen, C., Moyes, J., Tempia, S., Groome, M., Walaza, S., Pretorius, M., Naby, F., Mekgoe, O., Kahn, K., Von Gottberg, A., Wolter, N., Cohen, A.L., Von Mollendorf, C., Venter, M. & Madhi, S.A. Epidemiology of Acute Lower Respiratory Tract Infection in HIV-Exposed Uninfected Infants. Pediatrics. 2016;137(4):e20153272. en_ZA
dc.identifier.issn 0031-4005 (print)
dc.identifier.issn 1098-4275 (online)
dc.identifier.other 10.1542/peds.2015-3272
dc.identifier.uri http://hdl.handle.net/2263/61061
dc.language.iso en en_ZA
dc.publisher American Academy of Pediatrics en_ZA
dc.rights American Academy of Pediatrics en_ZA
dc.subject Infants en_ZA
dc.subject Infection en_ZA
dc.subject Human immunodeficiency virus (HIV) en_ZA
dc.subject HIV-exposed uninfected (HEU) en_ZA
dc.subject Lower respiratory tract infection (LRTI) en_ZA
dc.subject South Africa (SA) en_ZA
dc.title Epidemiology of acute lower respiratory tract infection in HIV exposed uninfected infants en_ZA
dc.type Article en_ZA


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