McMorrow, Meredith L.Tempia, StefanoWalaza, SibongileTreurnicht, Florette K.Moyes, JocelynCohen, Adam L.Pretorius, Marthi AndréaHellferscee, OrienkaWolter, NicoleVon Gottberg, AnneNguweneza, ArthemonMcAnerney, Johanna M.Naby, FathimaMekgoe, OmphileVenter, MarietjieMadhi, Shabir A.Cohen, Cheryl2019-08-212019-08-212019-03McMorrow, M.L., Tempia, S., Walaza, S. et al. 2019, 'The role of human immunodeficiency virus in influenza- and respiratory syncytial virus-associated hospitalizations in South African children, 2011-2016', Clinical Infectious Diseases, vol. 68, no. 5, pp. 773-780, https://doi.org/10.1093/cid/ciy532.1058-4838 (print)1537-6591 (online)10.1093/cid/ciy532http://hdl.handle.net/2263/71165BACKGROUND : Data describing influenza– or respiratory syncytial virus (RSV)–associated hospitalized illness in children aged <5 years in Africa are limited. METHODS : During 2011–2016, we conducted surveillance for severe respiratory illness (SRI) in children aged <5 years in 3 South African hospitals. Nasopharyngeal aspirates were tested for influenza and RSV using real-time reverse transcription polymerase chain reaction. We estimated rates of influenza- and RSV-associated hospitalized SRI by human immunodeficiency virus (HIV) status and compared children who tested positive for influenza vs RSV using multivariable penalized logistic regression. RESULTS : Among 3650 hospitalized children, 203 (5.6%) tested positive for influenza viruses, 874 (23.9%) for RSV, and 19 (0.5%) for both. The median age of children hospitalized with influenza was 13.9 months vs 4.4 months for RSV (P < .01). Annual influenza-associated hospitalization rates per 100000 were highest among infants aged 6–11 months (545; 95% confidence interval [CI], 409–703), while RSV-associated hospitalization rates were highest in infants aged 0–2 months (6593; 95% CI, 5947–7217). HIV exposure was associated with increased incidence of influenza- and RSV-associated hospitalization in infants aged 0–5 months, with relative risk (RR) 2.2 (95% CI, 1.4–3.4) and 1.4 (95% CI, 1.3–1.6), respectively. HIV infection was associated with increased incidence of influenza- and RSV-associated hospitalization in all age groups; RR 2.7 (95% CI, 2.0–3.5) and 3.8 (95% CI, 3.1–4.8), respectively. CONCLUSIONS : Influenza- and RSV-associated hospitalizations are common among South African infants. HIV infection and HIV exposure in infants increase risk of influenza- and RSV-associated hospitalization.en© Published by Oxford University Press for the Infectious Diseases Society of America 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.InfluenzaRespiratory syncytial virus (RSV)Human immunodeficiency virus (HIV)IncidenceSouth Africa (SA)Severe respiratory illness (SRI)Postprint Article