The role of influenza, RSV and other common respiratory viruses in severe acute respiratory infections and influenza-like illness in a population with a high HIV sero-prevalence, South Africa, 2012-2015

摘要

BACKGROUND : Viruses detected in patients with acute respiratory infections may be thecause of illness or colonizers.METHODS : We compared the prevalence of 10 common respiratory viruses (influenza Aand B viruses, parainfluenza virus 1, 2, and 3; respiratory syncytial virus (RSV);adenovirus, rhinovirus, human metapneumovirus (hMPV) and enterovirus) in patientshospitalized with severe acute respiratory illness (SARI), outpatients with influenza-likeillness (ILI), and control subjects who did not report any febrile, respiratory orgastrointestinal illness during 2012-2015 in South Africa. We estimated the attributablefraction (AF) and the detection rate attributable to illness for each of the differentrespiratory viruses. RESULTS : We enrolled 1959 SARI, 3784 ILI and 1793 controls. Influenza virus (AF:86.3%; 95%CI: 77.7%-91.6%), hMPV (AF: 85.6%%; 95%CI: 72.0%-92.6%), and RSV(AF: 83.7%; 95%CI: 77.5%-88.2%) infections were highly associated with severedisease, while rhinovirus (AF: 46.9%; 95%CI: 37.6%-56.5%) and adenovirus (AF:36.4%; 95%CI: 20.6%-49.0%) were only moderately associated. The estimateddetection rate associated with severe disease was: 20.2% for rhinovirus, 16.7% forRSV, 7.0% for adenovirus, 4.9% for influenza virus and 3.8% for hMPV. Similarpatterns were observed for patients with ILI. CONCLUSIONS : Influenza, RSV and hMPV can be considered likely pathogens ifdetected in patients with ILI and SARI while rhinovirus and adenovirus were commonlyidentified also among controls suggesting that they may cause only a proportion ofclinical disease observed in positive patients. Nonetheless, given their high estimateddetection rate attributable to illness, they may be important contributors to disease.