title: Severe influenza-associated respiratory infection in high HIV prevalence setting, South Africa, 2009-2011.
abstract: Data on influenza epidemiology in HIV-infected persons are limited, particularly for sub-Saharan Africa, where HIV infection is widespread. We tested respiratory and blood samples from patients with acute lower respiratory tract infections hospitalized in South Africa during 2009-2011 for viral and pneumococcal infections. Influenza was identified in 9% (1,056/11,925) of patients enrolled; among influenza case-patients, 358 (44%) of the 819 who were tested were infected with HIV. Influenza-associated acute lower respiratory tract infection incidence was 4-8 times greater for HIV-infected (186-228/100,000) than for HIV-uninfected persons (26-54/100,000). Furthermore, multivariable analysis showed HIV-infected patients were more likely to have pneumococcal co-infection; to be infected with influenza type B compared with type A; to be hospitalized for 2-7 days or >7 days; and to die from their illness. These findings indicate that HIV-infected persons are at greater risk for severe illnesses related to influenza and thus should be prioritized for influenza vaccination.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Cohen
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Moyes
authors.forename: Stefano
authors.initials: S
authors.lastname: Tempia
authors.forename: Michelle
authors.initials: M
authors.lastname: Groom
authors.forename: Sibongile
authors.initials: S
authors.lastname: Walaza
authors.forename: Marthi
authors.initials: M
authors.lastname: Pretorius
authors.forename: Halima
authors.initials: H
authors.lastname: Dawood
authors.forename: Meera
authors.initials: M
authors.lastname: Chhagan
authors.forename: Summaya
authors.initials: S
authors.lastname: Haffejee
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Variava
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kahn
authors.forename: Akhona
authors.initials: A
authors.lastname: Tshangela
authors.forename: Anne
authors.initials: A
authors.lastname: von Gottberg
authors.forename: Nicole
authors.initials: N
authors.lastname: Wolter
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
authors.forename: Babatyi
authors.initials: B
authors.lastname: Kgokong
authors.forename: Marietjie
authors.initials: M
authors.lastname: Venter
authors.forename: Shabir A
authors.initials: SA
authors.lastname: Madhi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007251:Influenza, Human / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D062486:Public Health Surveillance; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
keywords: AIDS; HIV; South Africa; adults; bacteria; children; co-infection; influenza; lower respiratory tract infection; pneumoccocus; pneumococcal; pneumonia; respiratory infections; vaccination; viruses