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

Across all age groups, HIV-positive patients had higher rates of RSV-associated SARI than those who were not infected with HIV, and they were hospitalized more often, although there was no meaningful difference in the death rates between the two groups. One group that did experience a significant increase in mortality was the RSV-infected elderly, whether they had HIV or not. Three of the 4 elderly RSV patients who died also had HIV, and 2 had other underlying infections (excluding HIV or tuberculosis), although this is an admittedly small sample. In general, older individuals with RSV spent longer periods of time hospitalized than younger individuals with RSV.
One possible explanation for the large number of RSV-infected patients in the study who also had HIV is that HIV compromises the immune system, hampering the ability of the body to fight RSV. “Available evidence suggests that the immune response to RSV infection requires both humoral and cellular elements, specifically CD4+ and CD8+ T cells which are critical in terminating an acute RSV infection,” the authors wrote in the discussion section of the report. They also noted that some studies suggest inflammatory cells may contribute to and worsen RSV: “Individuals with compromise to their immune systems, like HIV-infected adults, may be more at risk of severe infection but the role of a decreased immune response may need further description.”
The authors concluded by asserting that, if available, the RSV vaccine should be given to older individuals and possibly those infected with HIV in order to reduce the number of RSV-related SARI hospitalizations, at least in Africa or other locales that have a high number of individuals with HIV.
Laurie Saloman, MS, is a health writer with more than 20 years of experience working for both consumer and physician-focused publications. She is a graduate of Brandeis University and the Medill School of Journalism at Northwestern University. She lives in New Jersey with her family.
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