Von Mollendorf, ClaireHellferscee, OrienkaValley-Omar, ZiyaadTreurnicht, Florette K.Walaza, SibongileMartinson, Neil A.Lebina, LimakatsoMothlaoleng, KatlegoMahlase, GethwanaVariava, EbrahimCohen, Adam L.Venter, MarietjieCohen, CherylTembo, Stefano2018-10-092018-10Von Mollendorf, C., Hellferscee, O., Valley-Omar, Z. et al. 2018, 'Influenza viral shedding in a prospective cohort of HIV-infected and uninfected children and adults in 2 provinces of South Africa, 2012-2014', Journal of Infectious Diseases, vol. 218, no. 8, pp. 1228-1237.0022-1899 (print)1537-6613 (online)10.1093/infdis/jiy310http://hdl.handle.net/2263/66828BACKGROUND : Prolonged shedding of influenza viruses may be associated with increased transmissibility and resistance mutation acquisition due to therapy. We compared duration and magnitude of influenza shedding between human immunodeficiency virus (HIV)-infected and -uninfected individuals. METHODS : A prospective cohort study during 3 influenza seasons enrolled patients with influenza-like illness and a positive influenza rapid test. Influenza viruses were detected by real-time reverse transcription polymerase chain reaction. Weibull accelerated failure time regression models were used to describe influenza virus shedding. Mann-Whitney U tests explored initial influenza viral loads (VL). RESULTS : Influenza virus shedding duration was similar in 65 HIV-infected (6 days; interquartile range [IQR] 3–10) and 176 HIV-uninfected individuals (7 days; IQR 4–11; P = .97), as was initial influenza VL (HIV-uninfected 5.28 ± 1.33 log10 copies/mL, HIV-infected 4.73 ± 1.68 log10 copies/mL; P = .08). Adjusted for age, HIV-infected individuals with low CD4 counts shed influenza virus for longer than those with higher counts (adjusted hazard ratio 3.55; 95% confidence interval, 1.05–12.08). DISCUSSION : A longer duration of influenza virus shedding in HIV-infected individuals with low CD4 counts may suggest a possible increased risk for transmission or viral evolution in severely immunocompromised individuals. HIV-infected individuals should be prioritized for annual influenza immunization.en© The Author 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Infectious Diseases following peer review. The definitive publisher-authenticated version is : Influenza viral shedding in a prospective cohort of HIV-infected and uninfected children and adults in 2 provinces of South Africa, 2012-2014, Journal of Infectious Diseases, vol. 218, no. 8, pp. 1228-1237, 2018. doi : 10.1093/infdis/jiy310, is available online at : http://jid.oxfordjournals.org.InfluenzaSheddingHuman immunodeficiency virus (HIV)South Africa (SA)HIV infectionsPolymerase chain reaction (PCR)CD4 count determination procedureAdultsChildrenImmunocompromised hostOrthomyxoviridaePostprint Article