Human metapneumovirus-associated severe acute respiratory illness hospitalisation in HIV-infected and HIV-uninfected South African children and adults
Human metapneumovirus-associated severe acute respiratory illness hospitalisation in HIV-infected and HIV-uninfected South African children and adults
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DOI：
10.1016/j.jcv.2015.06.089
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发表时间：
2015-08-01
影响因子：
8.8
通讯作者：
Madhi, Shabir A.
中科院分区：
文献类型：
--
作者：
Groome, Michelle J.;Moyes, Jocelyn;Madhi, Shabir A.
背景：人类偏肺病毒(HMPV)相关的严重急性呼吸道疾病(SAI)的数据仅限于人类免疫缺陷病毒(HIV)感染的高流行率环境中。目的：描述儿童和成人中HMPV相关SARI的临床特征和季节性(所有地点)和发病率(仅限于索韦托)。研究设计：从2009年2月至2013年12月在南非的四个地点进行了积极的、前瞻性的、以医院为基础的哨点监测。上呼吸道标本用多重实时聚合酶链式反应检测HMPV和其他呼吸道病毒。结果：在入选的患者中，有4.1%的患者中发现了人乳头瘤病毒，其中儿童为5.6%(593/10503)，成人为1.7%(>；=18岁；119/6934)。大多数成年人(84.0%)有潜在的健康状况，包括87/110人(79.1%)感染艾滋病毒。HMPV的检测常年发生，检测周期增加，每年不同。在索韦托，与艾滋病毒相关的住院发生率在婴儿中最高(每100,000人年653.3例；95%可信区间602.2-707.6)。HIV感染者在5~17岁(RR6.0；1.1~20.4)、18~44岁(RR67.6；38.0~132.6)和45~(RR5.3；3.4~8.3)年龄段的发病率明显高于非HIV感染者。在儿童中，婴儿的风险最高，感染艾滋病毒和未感染艾滋病毒的儿童的住院负担相似。(C)2015爱思唯尔B.V.保留所有权利。
Background: Data on human metapneumovirus (HMPV)-associated severe acute respiratory illness (SARI) are limited in settings with high human immunodeficiency virus (HIV) infection prevalence.Objectives: To describe clinical characteristics and seasonality (all sites), and incidence (Soweto only) of HMPV-associated SARI among children and adults.Study design: Active, prospective, hospital-based, sentinel surveillance for patients hospitalised with SARI was conducted at four sites in South Africa from February 2009-December 2013. Upper respiratory tract samples were tested by multiplex real-time polymerase chain reaction assays for HMPV and other respiratory viruses. Incidence of hospitalisation, stratified by age and HIV-infection status, was calculated for one hospital with population denominators.Results: HMPV was identified in 4.1% of patients enrolled, including 5.6% (593/10503) in children and 1.7% in adults (>= 18 years; 119/6934). The majority of adults (84.0%) had an underlying medical condition, including HIV infection in 87/110 (79.1%). HMPV detection occurred perennially with periods of increased detection, which varied from year to year. The incidence of HMPV-associated hospitalisation in Soweto was highest in infants (653.3 per 100,000 person years; 95% confidence interval (CI) 602.2-707.6). The incidence was higher in HIV-infected persons compared to HIV-uninfected persons in age-groups 5-17 years (RR 6.0; 1.1-20.4), 18-44 years (RR 67.6; 38.0-132.6) and 45-64 years (RR 5.3; 3.4-8.3), while not differing in other age-groups.Conclusions: The burden of HMPV-associated SARI hospitalisation among adults occurred predominantly in HIV-infected persons. Among children, infants were at highest risk, with similar burden of hospitalisation in HIV-infected and HIV-uninfected children. (C) 2015 Elsevier B.V. All rights reserved.