Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting

Jocelyn Moyes; Sibongile Walaza; Marthi Pretorius; Michelle Groome; Anne von Gottberg; Nicole Wolter; Sumayya Haffejee; Ebrahim Variava; Adam L Cohen; Stefano Tempia; Kathleen Kahn; Halima Dawood; Marietjie Venter; Cheryl Cohen; Shabir A Madhi; South African Severe Acute Respiratory Illness (SARI) Surveillance Group

doi:10.1016/j.jinf.2017.06.007

Respiratory syncytial virus in adults with severe acute respiratory illness in a high HIV prevalence setting

J Infect. 2017 Oct;75(4):346-355. doi: 10.1016/j.jinf.2017.06.007. Epub 2017 Jul 1.

Authors

Jocelyn Moyes¹, Sibongile Walaza², Marthi Pretorius³, Michelle Groome⁴, Anne von Gottberg⁵, Nicole Wolter⁵, Sumayya Haffejee⁶, Ebrahim Variava⁷, Adam L Cohen⁸, Stefano Tempia⁹, Kathleen Kahn¹⁰, Halima Dawood¹¹, Marietjie Venter³, Cheryl Cohen², Shabir A Madhi¹²; South African Severe Acute Respiratory Illness (SARI) Surveillance Group

Affiliations

¹ Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Health Sciences Faculty, University of the Witwatersrand, Johannesburg, South Africa. Electronic address: jocelynm@nicd.ac.za.
² Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; School of Public Health, Health Sciences Faculty, University of the Witwatersrand, Johannesburg, South Africa.
³ Department of Medical Virology, University of Pretoria, South Africa.
⁴ Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa.
⁵ Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
⁶ National Health Laboratory Service, South Africa.
⁷ Klerksdorp-Tshepong Hospital Complex, South Africa; The University of the Witwatersrand, South Africa.
⁸ Strategic Information Group, Expanded Programme on Immunization, Department of Immunization, Vaccines and Biologicals, World Health Organization, Switzerland.
⁹ Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
¹⁰ MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Centre for Global Health Research and Umeå University, Umeå, Sweden; INDEPTH Network Accra, Ghana.
¹¹ Pietermaritzburg Hospital Complex and University of KwaZulu-Natal, Pietermaritzburg, South Africa.
¹² Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: There are limited data on the epidemiology of respiratory syncytial virus (RSV) illness in HIV-infected adults or the elderly in Africa. We studied the epidemiology of RSV-associated severe acute respiratory illness (SARI) hospitalizations in adults in South Africa from 2009 through 2013.

Methods: Individuals admitted to sentinel surveillance hospitals were investigated by respiratory tract swabs for RSV, using a multiplex real-time polymerase chain reaction assay. The incidence of RSV-associated SARI was calculated for the one site with population denominators.

Results: Of 7796 participants investigated, 329 (4%) tested positive for RSV. On multivariable analysis, HIV-infected individuals with RSV-associated SARI had greater odds of being in the age groups 18-44 and 45-64 years (odd ratios (OR) 26.3; 95% confidence interval (CI) 6.2-112.1 and OR 11.4; 95% CI 2.6-50.0) compared with those ≥65 years and being female (OR 2.7; 95% CI 1.4-5.4). The relative risk of hospitalization with RSV-associated SARI was 12-18 times higher in HIV infected individual compared to that of HIV-uninfected.

Conclusion: The incidence of RSV-associated SARI was higher in HIV-infected individuals and those aged 65 years and older. Further studies are warranted to describe the disease association of RSV detected in adults with SARI.

Keywords: HIV; Respiratory syncytial virus; South Africa.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Acute Disease
Adolescent
Adult
Aged
Child, Preschool
Female
HIV Infections / complications
HIV Infections / epidemiology*
HIV Infections / virology
Hospitalization / statistics & numerical data
Humans
Infant
Male
Middle Aged
Population Surveillance*
Prevalence
Real-Time Polymerase Chain Reaction
Respiratory Syncytial Virus Infections / epidemiology*
Respiratory Syncytial Virus Infections / virology
Respiratory Syncytial Virus, Human / genetics
Respiratory Syncytial Virus, Human / isolation & purification
Respiratory Tract Infections / epidemiology*
Respiratory Tract Infections / virology*
Sentinel Surveillance
South Africa / epidemiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding