The Role of Human Immunodeficiency Virus in Influenza- and Respiratory Syncytial Virus–associated Hospitalizations in South African Children, 2011–2016

Abstract

Influenza- and RSV-associated hospitalization are common among South African infants. HIV infection, and HIV exposure in infants, increase risk of influenza- and RSV-associated hospitalization.

Respiratory syncytial virus contributes to more severe respiratory morbidity than influenza in children < 2 years during seasonal influenza peaks

“…Conversely, young infants infected with influenza had a significantly higher rate of fever than children with RSV infection. These results are consistent with previous reports on the RSV and influenza clinical features in young children [8,9]. We also found that a radiologically confirmed pneumonia was more frequent in RSV infection than in influenza infection, which is in line with other publications [7,8].…”

“…We found the highest rate of RSV among infants aged 3-5 months with RSV detection in nearly three over four patients (73.5%) followed by infants < 3 months (53.7%). Similar to our results, other reports found that infants aged 3-5 months had the highest proportion of RSV detection [3,10], while the highest RSV frequency in the South African study was among infants < 3 months [9].…”

“…Conducted mainly among children < 5 years in early 2000s, these studies reported similar patterns of high RSV detection (20-38%) relative to influenza (3-15%). A recent study from South Africa reported that during a 5-year period (2011-2016), RSV was more often detected (24%) than influenza viruses (6%) in children < 5 years [9]. We found the highest rate of RSV among infants aged 3-5 months with RSV detection in nearly three over four patients (73.5%) followed by infants < 3 months (53.7%).…”

Diagnosis and management of community-acquired pneumonia in children: South African Thoracic Society guidelines

“…[10] HEU infants have an increased risk of hospitalisation compared to HIV-unexposed infants and an increased risk of in-hospital death, predominantly in the first 6 months of life. [11,12] Increased risk of hospitalisation in HEU infants has also been found for specific pathogens such as pneumococcus, respiratory syncytial virus (RSV) and influenza virus. [10,11,13] Additional risk factors for severe pneumonia include infancy (particularly those <4 months), premature birth, incomplete immunisation, maternal smoking or household tobacco smoke exposure, indoor air pollution, low birthweight, malnutrition, lack of exclusive breastfeeding and overcrowding.…”

RespiDisk: a point-of-care platform for fully automated detection of respiratory tract infection pathogens in clinical samples

“…In addition, it can often be the case that RTIs exist simultaneously with underlying co-morbidities, such as tropical diseases in Low-and Middle-Income Countries, 11,12 cancer and HIV, 12,13 or sudden outbreaks of epidemics/pandemics, especially of respiratory nature like the SARS-CoV-2. 14,15 In such occasions, the epidemiological landscape becomes even more complicated, requiring accurate diagnosis of the RTI-causative pathogen for proper management of patients with comorbidities.…”