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Respiratory Syncytial Virus and HIV—What's the Connection?

Respiratory Syncytial Virus (RSV) is a virus that infiltrates the lungs and airways. Nearly all children in the United States have contracted RSV by the age of 2, and it usually results in nothing more than a week or so of cold-like symptoms, although infants and older people are at greater risk of serious illness. Thousands of young children are hospitalized for RSV each year in the United States; worldwide, the disease kills 160,000 people yearly.
Due to a lack of research on the connection between RSV and HIV in locations where the latter infection is prevalent, a team of scientists from the National Institute for Communicable Diseases and the University of the Witwatersrand, both in Johannesburg, South Africa, along with scientists from additional South African health entities, conducted a study to determine how HIV might be linked with the frequency and severity of RSV-associated severe acute respiratory illness (SARI) in South African adults.
The team studied data from February 2009 through December 2013, culled from hospitals in 4 South African provinces. During that time period, adults who had been experiencing symptoms of SARI for fewer than 7 days were screened and, in some cases, enrolled in a SARI surveillance program. Symptoms included sudden fever, cough, sore throat, and shortness of breath. Samples of their respiratory secretions were analyzed, and HIV testing was performed at the admitting physicians’ request. In total, 7872 patients were enrolled in the surveillance program, 99% of whom were given a test for RSV. HIV test results were also available for 89% of patients in the program.
Overall, the rate of RSV found in this population sample was fairly low—228 of the 5297 individuals who tested positive for HIV (4%) and 57 of the 1708 individual who were not infected with HIV (3%). However, of the small number of individuals who were found to have RSV, the overwhelming majority also were found to have HIV—228 out of 285, or 80%. The HIV burden among RSV-positive patients was disproportionately carried by the young: 87% of those co-infected were between the ages of 18 and 44, 73% were between the ages of 45 and 64, and just 21% were at least 65 years old. Fewer than half of surveillance-study participants who were found to be positive for HIV had begun antiretroviral treatment when admitted to the hospital.

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