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Meta-Analysis
. 2019 Aug:117:96-102.
doi: 10.1016/j.jcv.2019.06.006. Epub 2019 Jun 28.

Case fatality rate and viral aetiologies of acute respiratory tract infections in HIV positive and negative people in Africa: The VARIAFRICA-HIV systematic review and meta-analysis

Sebastien Kenmoe  1 , Jean Joel Bigna  2 , Abdou Fatawou Modiyingi  3 , Marie S Ndangang  4 , Paul Alain Ngoupo  5 , Fredy Brice N Simo  6 , Serges Tchatchouang  7 , Elvis Temfack  8 , Richard Njouom  9
Affiliations
Meta-Analysis

Case fatality rate and viral aetiologies of acute respiratory tract infections in HIV positive and negative people in Africa: The VARIAFRICA-HIV systematic review and meta-analysis

Sebastien Kenmoe et al. J Clin Virol. 2019 Aug.

Abstract

Background: To set priorities for efficient control of acute respiratory tract infection (ARTI) in Africa, it is necessary to have accurate estimate of its burden, especially among HIV-infected populations.

Objectives: To compare case fatality rate (CFR) and viral aetiologies of ARTI between HIV-positive and HIV-negative populations in Africa.

Study design: We searched PubMed, EMBASE, Web of Knowledge, Africa Journal Online, and Global Index Medicus to identify studies published from January 2000 to April 2018. Random-effect meta-analysis method was used to assess association (pooled weighted odds ratios (OR) with 95% confidence interval (CI)).

Results: A total of 36 studies (126,526 participants) were included. CFR was significantly higher in patients with HIV than in HIV-negative controls (OR 4.10, 95%CI: 2.63-6.27, I²: 93.7%). The risk was significantly higher among children ≤5 years (OR 5.51, 95%CI 2.83-10.74) compared to people aged >5 years (OR 1.48, 95%CI 1.17-1.89); p = 0.0002. There was no difference between children (15 years) and adults and between regions of Africa. There was no difference for viral respiratory aetiologies (Enterovirus, Adenovirus, Bocavirus, Coronavirus, Metapneumovirus, Parainfluenza, Influenza, and Respiratory Syncytial Virus) of ARTI between HIV-positive and HIV-negative people, except for Rhinovirus where being HIV-negative was associated with Rhinovirus (OR 0.70; 95%CI 0.51-0.97, I²: 63.4%).

Conclusions: This study shows an increased risk of deaths among HIV-infected individuals with ARTI, however with no difference in viral aetiologies compared to HIV-negative individuals in Africa. ARTI deserves more attention from HIV health-care providers for efficient control. Specific strategies are needed for HIV-positive children under 5.

Keywords: AIDS; Acute respiratory infections; Africa; Epidemiology; HIV; Mortality.

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Figures

Fig. 1
Fig. 1
Flow diagram of study selection.
Fig. 2
Fig. 2
Comparison of case fatality rate between HIV-positive and HIV-negative populations with acute respiratory tract infections in Africa.
Fig. 3
Fig. 3
Comparison of viral aetiologies of acute respiratory tract infections between HIV-positive and HIV-negative populations with in Africa.
See this image and copyright information in PMC

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