Viral pathogens including human metapneumovirus are the primary cause of febrile respiratory illness in HIV-infected adults receiving antiretroviral therapy.
To determine the spectrum of pathogens causing acute febrile respiratory illness in human immunodeficiency virus (HIV)-infected adults, we re-analyzed data from a prospective surveillance study involving 50 outpatients (90% of whom received highly active antiretroviral therapy). Nasopharyngeal samples were tested for 23 respiratory viruses by multiplex reverse-transcriptase polymerase chain reaction (PCR) and for atypical bacteria by PCR. Sputum cultures and serological testing were performed. Viruses accounted for 64% of infections. After influenza (22 cases), human metapneumovirus infection (6 cases) was most common and was associated with bronchospasm. Bacterial infections occurred in 6 patients (3 of whom had concurrent viral infection). Over 80% of patients received antibiotics. Rapid testing to identify specific viral pathogens could aid in patient management and reduce unnecessary antibiotic exposure.
Klein
Marina B
MB
Department of Medicine, Divisions of Infectious Diseases/Immunodeficiency, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada. marina.klein@mcgill.ca
Yang
Hong
H
DelBalso
Lina
L
Carbonneau
Julie
J
Frost
Eric
E
Boivin
Guy
G
D017088:AIDS-Related Opportunistic Infections; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D005334:Fever / Q000821:virology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008297:Male; D029121:Metapneumovirus; D008875:Middle Aged; D010045:Outpatients; D018184:Paramyxoviridae Infections / Q000150:complications* / Q000453:epidemiology; D011159:Population Surveillance; D011446:Prospective Studies; D011792:Quebec / Q000453:epidemiology; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult