Claire von Mollendorf1,2, Orienka Hellferscee1,3, Ziyaad Valley-Omar1,4, Florette K Treurnicht1, Sibongile Walaza1,2, Neil A Martinson5, Limakatso Lebina5, Katlego Mothlaoleng5, Gethwana Mahlase6, Ebrahim Variava7,8, Adam L Cohen9,10, Marietjie Venter11, Cheryl Cohen1,2, Stefano Tempia9,10. 1. Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg. 2. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg. 3. School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg. 4. Department of Pathology, Division of Medical Virology, University of Cape Town. 5. Perinatal HIV Research Unit, Medical Research Council Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg. 6. Pietermaritzburg Metropolitan, KwaZulu-Natal. 7. School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg. 8. Department of Medicine, Klerksdorp Tshepong Hospital, North West Province. 9. Influenza Division, Centers for Disease Control and Prevention, Pretoria. 10. Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia. 11. Department of Medical Virology, University of Pretoria, Pretoria, South Africa.
Abstract
Background: Prolonged shedding of influenza viruses may be associated with increased transmissibility and resistance mutation acquisition due to therapy. We compared duration and magnitude of influenza shedding between human immunodeficiency virus (HIV)-infected and -uninfected individuals. Methods: A prospective cohort study during 3 influenza seasons enrolled patients with influenza-like illness and a positive influenza rapid test. Influenza viruses were detected by real-time reverse transcription polymerase chain reaction. Weibull accelerated failure time regression models were used to describe influenza virus shedding. Mann-Whitney U tests explored initial influenza viral loads (VL). Results: Influenza virus shedding duration was similar in 65 HIV-infected (6 days; interquartile range [IQR] 3-10) and 176 HIV-uninfected individuals (7 days; IQR 4-11; P = .97), as was initial influenza VL (HIV-uninfected 5.28 ± 1.33 log10 copies/mL, HIV-infected 4.73 ± 1.68 log10 copies/mL; P = .08). Adjusted for age, HIV-infected individuals with low CD4 counts shed influenza virus for longer than those with higher counts (adjusted hazard ratio 3.55; 95% confidence interval, 1.05-12.08). Discussion: A longer duration of influenza virus shedding in HIV-infected individuals with low CD4 counts may suggest a possible increased risk for transmission or viral evolution in severely immunocompromised individuals. HIV-infected individuals should be prioritized for annual influenza immunization.
Background: Prolonged shedding of influenza viruses may be associated with increased transmissibility and resistance mutation acquisition due to therapy. We compared duration and magnitude of influenza shedding between humanimmunodeficiency virus (HIV)-infected and -uninfected individuals. Methods: A prospective cohort study during 3 influenza seasons enrolled patients with influenza-like illness and a positive influenza rapid test. Influenza viruses were detected by real-time reverse transcription polymerase chain reaction. Weibull accelerated failure time regression models were used to describe influenza virus shedding. Mann-Whitney U tests explored initial influenza viral loads (VL). Results:Influenza virus shedding duration was similar in 65 HIV-infected (6 days; interquartile range [IQR] 3-10) and 176 HIV-uninfected individuals (7 days; IQR 4-11; P = .97), as was initial influenza VL (HIV-uninfected 5.28 ± 1.33 log10 copies/mL, HIV-infected 4.73 ± 1.68 log10 copies/mL; P = .08). Adjusted for age, HIV-infected individuals with low CD4 counts shed influenza virus for longer than those with higher counts (adjusted hazard ratio 3.55; 95% confidence interval, 1.05-12.08). Discussion: A longer duration of influenza virus shedding in HIV-infected individuals with low CD4 counts may suggest a possible increased risk for transmission or viral evolution in severely immunocompromised individuals. HIV-infected individuals should be prioritized for annual influenza immunization.
Authors: Caroline Chartrand; Mariska M G Leeflang; Jessica Minion; Timothy Brewer; Madhukar Pai Journal: Ann Intern Med Date: 2012-02-27 Impact factor: 25.391
Authors: Thorsten Suess; Udo Buchholz; Susann Dupke; Roland Grunow; Matthias an der Heiden; Alla Heider; Barbara Biere; Brunhilde Schweiger; Walter Haas; Gérard Krause Journal: Am J Epidemiol Date: 2010-05-03 Impact factor: 4.897
Authors: Christopher E Ormsby; Daniela de la Rosa-Zamboni; Joel Vázquez-Pérez; Yuria Ablanedo-Terrazas; Ricardo Vega-Barrientos; María Gómez-Palacio; Akio Murakami-Ogasawara; Jorge A Ibarra-Ávalos; Dámaris Romero-Rodríguez; Santiago Avila-Ríos; Gustavo Reyes-Terán Journal: AIDS Date: 2011-02-20 Impact factor: 4.177
Authors: Mark J Siedner; Courtney K Ng; Ingrid V Bassett; Ingrid T Katz; David R Bangsberg; Alexander C Tsai Journal: Clin Infect Dis Date: 2014-12-16 Impact factor: 9.079
Authors: Mpho Seleka; Florette K Treurnicht; Stefano Tempia; Orienka Hellferscee; Senzo Mtshali; Adam L Cohen; Amelia Buys; Johanna M McAnerney; Terry G Besselaar; Marthi Pretorius; Anne von Gottberg; Sibongile Walaza; Cheryl Cohen; Shabir A Madhi; Marietjie Venter Journal: PLoS One Date: 2017-05-25 Impact factor: 3.240
Authors: David Bell; Angus Nicoll; Keiji Fukuda; Peter Horby; Arnold Monto; Frederick Hayden; Clare Wylks; Lance Sanders; Jonathan Van Tam Journal: Emerg Infect Dis Date: 2006-01 Impact factor: 6.883
Authors: Laura M Vos; Jesper M Weehuizen; Andy I M Hoepelman; Karin H A H Kaasjager; Annelies Riezebos-Brilman; Jan Jelrik Oosterheert Journal: J Clin Virol Date: 2019-04-07 Impact factor: 3.168
Authors: M M van der Zalm; E Walters; M Claassen; M Palmer; J A Seddon; A M Demers; M L Shaw; E D McCollum; G U van Zyl; A C Hesseling Journal: BMC Infect Dis Date: 2020-12-04 Impact factor: 3.090
Authors: Emmanuel Margolin; Wendy A Burgers; Edward D Sturrock; Marc Mendelson; Rosamund Chapman; Nicola Douglass; Anna-Lise Williamson; Edward P Rybicki Journal: Nat Rev Microbiol Date: 2020-09-10 Impact factor: 60.633