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. 2014 Dec;61(4):571-8.
doi: 10.1016/j.jcv.2014.10.013. Epub 2014 Oct 28.

Polyomaviruses-associated respiratory infections in HIV-infected and HIV-uninfected children

Marta C Nunes  1 , Zachary Kuschner  2 , Zelda Rabede  3 , Clare L Cutland  1 , Richard Madimabe  1 , Locadiah Kuwanda  1 , Keith P Klugman  4 , Peter V Adrian  1 , Shabir A Madhi  5
Affiliations

Polyomaviruses-associated respiratory infections in HIV-infected and HIV-uninfected children

Marta C Nunes et al. J Clin Virol. 2014 Dec.

Abstract

Background: Two recently discovered polyomaviruses (PyV), WU and KI, have been identified in respiratory-tract specimens from children with acute respiratory infections, although there are limited data in HIV-infected children.

Objectives: To determine the prevalence and clinical manifestations of WUPyV and KIPyV-associated lower respiratory tract infections (LRTIs) hospitalization in HIV-infected and -uninfected children; and probe the role of pneumococcal co-infection.

Study design: Nasopharyngeal aspirates were collected from a cohort of 39,836 children randomized to receive 9-valent pneumococcal conjugate vaccine (PCV9) or placebo when hospitalized for LRTIs, and were screened by PCR for WUPyV, KIPyV and other respiratory viruses.

Results: In placebo-recipients the prevalence of WUPyV was 6.3% (18/285) in HIV-infected and 13.9% (66/476) in HIV-uninfected children (p=0.002). In WUPyV-positive LRTIs HIV-infected children had lower oxygen saturation at admission and a higher case fatality rate (11.1% vs. 0%; p=0.04). KIPyV was identified in 10.2% (29/285) of HIV-infected and in 7.4% (35/476) of HIV-uninfected placebo-recipients with LRTIs (p=0.13). HIV-infected compared to HIV-uninfected children with KIPyV-positive LRTIs had lower oxygen saturation, higher respiratory rate and longer duration of hospitalization. Co-infections with other respiratory-viruses were detected in 65.5% of WUPyV-positive LRTIs and in 75.0% of KIPyV-positive LRTIs. Among HIV-uninfected children, there was a lower incidence of hospitalization for clinical pneumonia episodes in which KIPyV (80%; 95% CI: 41, 93) and WUPyV (49%; 95% CI: 9, 71) were identified among PCV9-recipients compared to placebo-recipients.

Conclusions: Polyomaviruses were commonly identified in HIV-infected and -uninfected children hospitalized for LRTIs, frequently in association with other viruses and may contribute to the pathogenesis of pneumococcal pneumonia.

Keywords: HIV; PCV9; Pneumococcal vaccine; Pneumonia; Polyomaviruses; Respiratory infections.

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Figures

Fig. 1
Fig. 1
Seasonal variation in identifying WU- and KI-polyomavirus in children hospitalized for lower respiratory tract infection between February 2000 until January 2002.
See this image and copyright information in PMC

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