Influenzavirus Infection Is a Primary Cause of Febrile Respiratory Illness in HIV-Infected Adults, Despite Vaccination

"There are, to our knowledge, no prospective studies of respiratory tract infections in [HIV]-infected adults in the highly active antiretroviral therapy (HAART) era. We performed a surveillance study of outpatients who presented with fever and respiratory symptoms to examine the role of viral pathogens in these patients," explained the researchers.

From 2003 to 2006, consecutive patients with a temperature of >38.0°C and respiratory symptoms were recruited from a tertiary care HIV clinic. Real-time multiplex polymerase chain reaction assays were used to test nasal pharyngeal samples for influenzavirus A and B, respiratory syncytial virus and human metapneumovirus. Paired acute- and convalescent-phase serum samples were tested for respiratory viruses by complement fixation.

Fifty patients (90 percent of whom were receiving HAART) participated in the study (median CD4+ T cell count, 325 cells/microliter; median HIV RNA level, "Although illness was mild, influenza accounted for a large proportion of unscheduled visits to a health care provider for respiratory illness and was associated with unnecessary antibiotic prescriptions that may contribute to antimicrobial resistance," the researchers concluded. "Vaccination alone was insufficient to prevent infection. Thus, specific identification and management of influenza should be performed in HIV-infected outpatients who present with fever and respiratory symptoms."

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