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. 2017 Feb 15;64(4):443-450.
doi: 10.1093/cid/ciw756.

Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children

Natalie I Mazur  1   2   3 , Louis Bont  2   4 , Adam L Cohen  5   6 , Cheryl Cohen  7   8 , Anne von Gottberg  8   9 , Michelle J Groome  1   10 , Orienka Hellferscee  8   9 , Kerstin Klipstein-Grobusch  3   7 , Omphile Mekgoe  11 , Fathima Naby  12 , Jocelyn Moyes  7   8 , Stefano Tempia  5   6 , Florette K Treurnicht  8 , Marietje Venter  13   14 , Sibongile Walaza  7   8 , Nicole Wolter  8   9 , Shabir A Madhi  1   10 ; South African Severe Acute Respiratory Illness (SARI) Surveillance Group
Affiliations

Severity of Respiratory Syncytial Virus Lower Respiratory Tract Infection With Viral Coinfection in HIV-Uninfected Children

Natalie I Mazur et al. Clin Infect Dis. .

Erratum in

  • Errata.
    [No authors listed] [No authors listed] Clin Infect Dis. 2017 Jul 15;65(2):357. doi: 10.1093/cid/cix236. Clin Infect Dis. 2017. PMID: 28931268 Free PMC article. No abstract available.

Abstract

Background: Molecular diagnostics enable sensitive detection of respiratory viruses, but their clinical significance remains unclear in pediatric lower respiratory tract infection (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort.

Methods: Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for severe acute respiratory illness (SARI) hospitalization conducted in South Africa during February 2009-December 2013. The primary outcome was life-threatening disease, defined as mechanical ventilation, intensive care unit admission, or death.

Results: Of 2322 HIV-uninfected children with respiratory syncytial virus (RSV)-associated LRTI, 1330 (57.3%) had RSV monoinfection, 38 (1.6%) had life-threatening disease, 575 (24.8%) had rhinovirus, 347 (14.9%) had adenovirus (ADV), and 30 (1.3%) had influenza virus. RSV and any other viral coinfection was not associated with severe disease, ADV coinfection had increased odds of life-threatening disease (adjusted OR, 3.4; 95% CI, 1.6-7.2; P = .001), and influenza coinfection had increased odds of life-threatening disease and prolonged length of stay (adjusted OR, 2.1; 95% CI, 1.0-4.5; P = .05) compared with RSV monoinfection.

Conclusions: RSV coinfection with any respiratory virus is not associated with more severe disease when compared to RSV alone in this study. However, increased life-threatening disease in RSV-ADV and RSV-influenza coinfection warrants further study.

Keywords: lower respiratory tract infection disease severity; respiratory syncytial virus; viral coinfection.

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Figures

Figure 1.
Figure 1.
Histogram of adenovirus cycle threshold (Ct) values in human immunodeficiency virus-uninfected children <5 years of age with adenovirus (ADV) monoinfection and those with respiratory syncytial virus (RSV)–ADV coinfection at 6 sentinel sites in South Africa, 2009–2013.
See this image and copyright information in PMC

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