Respiratory syncytial virus illnesses in human immunodeficiency virus- and noninfected children.
Respiratory syncytial virus (RSV) lower respiratory tract and febrile upper respiratory tract illnesses were prospectively assessed in cohorts of 83 infants born to human immunodeficiency virus (HIV)- and of 48 infants born to non-HIV-infected mothers. Of the infants born to HIV-infected mothers, 18 were themselves infected with HIV, 26 were indeterminant and 39 were free from HIV. Ten RSV illnesses occurred in 8 HIV-infected, 2 illnesses in 2 indeterminant and 17 illnesses occurred in 17 non-HIV-infected children. RSV shedding was prolonged in HIV class P2- vs. non-HIV-infected children, at medians of 30 days (range, 1 to 199 days) and 6 days (range, 1 to 21 days), respectively (P = 0.02). Ribavirin and intravenous immunoglobulin failed to eradicate RSV from one child who shed virus for 199 days. Wheezing occurred in 1 of 4 vs. 9 of 10 episodes of lower respiratory tract illness in HIV-infected and non-HIV-infected children, respectively (P = 0.04). No differences were noted in duration of illness, temperature, respiratory rate or oxygen saturation between HIV- and non-HIV-infected children. Infection control and public health concerns regarding prolonged shedding of RSV in HIV-infected children must be recognized.
King
J C
JC
Department of Pediatrics, University of Maryland School of Medicine, Baltimore 21201.
Burke
A R
AR
Clemens
J D
JD
Nair
P
P
Farley
J J
JJ
Vink
P E
PE
Batlas
S R
SR
Rao
M
M
Johnson
J P
JP
D017088:AIDS-Related Opportunistic Infections; D001988:Bronchiolitis / Q000382:microbiology; D003440:Croup / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011014:Pneumonia / Q000382:microbiology; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000382:microbiology; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000382:microbiology*