Clinical Epidemiology of Bocavirus, Rhinovirus, Two Polyomaviruses and Four Coronaviruses in HIV-Infected and HIV-Uninfected South African Children

Abstract

BackgroundAdvances in molecular diagnostics have implicated newly-discovered respiratory viruses in the pathogenesis of pneumonia. We aimed to determine the prevalence and clinical characteristics of human bocavirus (hBoV), human rhinovirus (hRV), polyomavirus-WU (WUPyV) and –KI (KIPyV) and human coronaviruses (CoV)-OC43, -NL63, -HKU1 and -229E among children hospitalized with lower respiratory tract infections (LRTI).MethodsMultiplex real-time reverse-transcriptase polymerase chain reaction was undertaken on archived nasopharyngeal aspirates from HIV-infected and –uninfected children (<2 years age) hospitalized for LRTI, who had been previously investigated for respiratory syncytial virus, human metapneumovirus, parainfluenza I–III, adenovirus and influenza A/B.ResultsAt least one of these viruses were identified in 274 (53.0%) of 517 and in 509 (54.0%) of 943 LRTI-episodes in HIV-infected and -uninfected children, respectively. Human rhinovirus was the most prevalent in HIV-infected (31.7%) and –uninfected children (32.0%), followed by CoV-OC43 (12.2%) and hBoV (9.5%) in HIV-infected; and by hBoV (13.3%) and WUPyV (11.9%) in HIV-uninfected children. Polyomavirus-KI (8.9% vs. 4.8%; p = 0.002) and CoV-OC43 (12.2% vs. 3.6%; p<0.001) were more prevalent in HIV-infected than –uninfected children. Combined with previously-tested viruses, respiratory viruses were identified in 60.9% of HIV-infected and 78.3% of HIV-uninfected children. The newly tested viruses were detected at high frequency in association with other respiratory viruses, including previously-investigated viruses (22.8% in HIV-infected and 28.5% in HIV–uninfected children).ConclusionsWe established that combined with previously-investigated viruses, at least one respiratory virus was identified in the majority of HIV-infected and HIV-uninfected children hospitalized for LRTI. The high frequency of viral co-infections illustrates the complexities in attributing causality to specific viruses in the aetiology of LRTI and may indicate a synergetic role of viral co-infections in the pathogenesis of childhood LRTI.

Respiratory viruses in young South African children with acute lower respiratory infections and interactions with HIV

“…Identification of at least one respiratory virus was more common among ALRI cases compared with controls (84% vs. 70%). We identified a higher prevalence of respiratory viruses as well as viral co-infections (51% in cases and 44% in controls) than previously reported in young children with or without ALRI in South Africa [18,23,24]. However, comparable rates have been reported in paediatric ALRI populations outside South Africa [25], and a possible explanation for this may be environmental or genetic factors.…”

“…However, Moyes et al found that HIV-infected children in South Africa had a higher risk of hospitalization with RSV-associated ALRI than HIV-uninfected children [27]. In another South African study, HIVinfected children had a higher prevalence of KI polyomaviruses and coronavirus-OC43 and a lower prevalence of human bocavirus and WU polyomaviruses than in HIV-uninfected children [18]. There are limited viral data on HIV-infected children with ALRI [24,28] and further studies including a larger HIV-infected cohort are needed.…”

“…Few studies have investigated the viral aetiology of ALRI in HIV-infected children. A recent study from South Africa reported that a respiratory virus was identified in the majority of both HIV-infected and HIV-uninfected children, with RV being the most frequently identified [18]. No studies have investigated RV species in HIV-infected children.…”

C-Reactive Protein and Respiratory Viral Infection

“…Moreover, the highest positive rate was in patients younger than 10 years of age, consistent with previous studies [1,3,22]. Our findings were also consistent with other reports in terms of the most commonly identified viruses (i.e., HRV and RSV A) [1,22].…”

Fatal human coronavirus 229E (HCoV-229E) and RSV–Related pneumonia in an AIDS patient from Colombia

“…There is a lack of reported cases of a human coronavirus infection in HIV infected patients from Colombia and South America, confirmed by RT-PCR. HCoV-229E causes common cold but occasionally it can be associated with more severe respiratory infections in children [3,4], elderly and persons with underlying illness [3,5], which would be the case of HIV infection, as seen in this report [4,6].…”