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

• Type of Material: Article
• Authors: Marta C. Nunes, Department of Science and Technology; Zachary Kuschner, Stony Brook University; Zelda Rabede, University of Witwatersrand; Richard Madimabe, University of Witwatersrand; Nadia Van Niekerk, University of Witwatersrand; Jackie Moloi, BioMerieux; Locadiah Kuwanda, University of Witwatersrand; John W. Rossen, University of Groningen; Keith Klugman, Emory University; Peter V. Adrian, University of Witwatersrand; Shabir A. Madhi, University of Witwatersrand
• Language: English
• Date: 2014-02-03
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2014 Nunes et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pone.0086448
• Title of Journal or Parent Work: PLoS ONE
• ISSN: 1932-6203
• Volume: 9
• Issue: 2
• Start Page: e86448
• End Page: e86448
• Grant/Funding Information: This work is based upon research supported in-part by the South African Research Chairs Initiative of the Department of Science and Technology (DST) and National Research Foundation (NRF) in Vaccine Preventable Diseases. Additional funding support was received from the National Health Laboratory Service Research Fund and Medical Research Council (Respiratory and Meningeal Pathogens Research Unit).; Any opinion, findings and conclusions or recommendations expressed in this material are those of the author(s) and therefore the NRF and DST do not accept any liability with regard thereto.; MCN had financial support from the University of the Witwatersrand.; The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
• Keywords: DISEASE; CARE; MULTIPLE; PNEUMOCOCCAL CONJUGATE VACCINE; Multidisciplinary Sciences; RESPIRATORY-TRACT INFECTIONS; HOSPITALIZED CHILDREN; VIRUS; YOUNG-CHILDREN; Science & Technology; Science & Technology - Other Topics; WU POLYOMAVIRUS; PNEUMONIA ETIOLOGY
• Research Categories: Biology, Virology; Health Sciences, Epidemiology

Abstract

Background: Advances 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). Methods: Multiplex 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. Results: At 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). Conclusions: We 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 coinfections 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.