Seasonality, incidence, and repeat human metapneumovirus lower respiratory tract infections in an area with a high prevalence of human immunodeficiency virus type-1 infection
Seasonality, incidence, and repeat human metapneumovirus lower respiratory tract infections in an area with a high prevalence of human immunodeficiency virus type-1 infection
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DOI：
10.1097/inf.0b013e3180621192
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发表时间：
2007-08-01
影响因子：
3.6
通讯作者：
Klugman, Keith P.
中科院分区：
文献类型：
--
作者：
Madhi, Shabir A.;Ludewick, Herbert;Klugman, Keith P.
背景资料：关于非洲人偏肺病毒（hMPV）的流行病学信息有限，尽管它被确定为儿童肺炎的常见病原体。目的：确定1型人类免疫缺陷病毒（HIV）感染和未感染儿童中严重hMPV相关下呼吸道感染（LRTI）的流行病学。采用免疫荧光法分析了2000年1月至2002年12月因下呼吸道感染住院的儿童鼻咽吸出物样本中常见的呼吸道病毒;用逆转录聚合酶链反应（RT-PCR）检测2715例鼻咽分泌物中hMPV的表达。结果：hMPV是HIV非感染儿童中第二常见的呼吸道病毒（11.3%对21.1%），hMPV是HIV非感染儿童中第二常见的呼吸道病毒（11.3%对21.1%，P < 0.0001）。HIV感染儿童（2935/100，000）因hMPV-LRTI住院治疗的负担是HIV未感染儿童[575/100，000（95%CI：472-695）]的5.4倍（95%CI：3.5-7.5）。与未感染儿童相比，感染艾滋病毒的儿童有更多的细菌合并感染的证据，死亡率也更高。重复hMPV相关住院治疗涉及同源（B2亚群）和异源（A1和B2）hMPV。结论：hMPV-LRTI负担很高，并且病毒的同源和异源亚群会发生重复严重感染。
Background: There is limited information regarding the epidemiology of human metapneumovirus (hMPV) from Africa, despite it being identified as a common pathogen in children with pneumonia.Objectives: Determine the epidemiology of severe hMPV-associated lower respiratory tract infection (LRTI) in human immunodeficiency virus type-1 (HIV) infected and uninfected children.Methods: Nasopharyngeal aspirate samples from children hospitalized for LRTI between January 2000 and December 2002 were analyzed for common respiratory viruses using an immunfluorescence assay; and 2715 available nasopharyngeal aspirate samples were tested for hMPV by reverse-transcriptase polymerase chain reaction targeting its fusion protein. Phylogenetic analysis of the fusion (F) gene was performed on samples associated with repeat hMPV infections in the same child.Results: hMPV was identified perennially and was the second most commonly identified respiratory virus (11.3% versus 21.1% for respiratory syncytial virus, P < 0.0001) in HIV-uninfected children. The burden of hospitalization for hMPV-LRTI was 5.4 (95% CI: 3.5-7.5) fold greater in HIV-infected (2935 per 100,000) compared with HIV-uninfected children [575 (95% CI: 472-695) per 100,000]. HIV-infected children had greater evidence of bacteria] coinfection and a higher mortality rate than did uninfected children. Repeat hMPV associated hospitalizations involved homologous (B2 subgroup) and heterologous (A1 and B2) hMPV.Conclusions: There is a high burden of hMPV-LRTI and repeat severe infections occur from homologous and heterologous subgroups of the virus.