Polyomaviruses-associated respiratory infections in HIV-infected and HIV-uninfected children

• Type of Material: Article
• Authors: Marta C. Nunes, University of Witwatersrand; Zachary Kuschner, SUNY Stony Brook; Zelda Rabede, University of Witwatersrand; Clare L. Cutland, University of Witwatersrand; Richard Madimabe, University of Witwatersrand; Locadiah Kuwanda, University of Witwatersrand; Keith Klugman, Emory University; Peter V. Adrian, University of Witwatersrand; Shabir A. Madhi, University of Witwatersrand
• Language: English
• Date: 2014-12-01
• Publisher: ELSEVIER SCIENCE BV
• Publication Version: Final Published Version
• Copyright Statement: © 2014 Elsevier B.V.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jcv.2014.10.013
• Title of Journal or Parent Work: JOURNAL OF CLINICAL VIROLOGY
• Volume: 61
• Issue: 4
• Start Page: 571
• End Page: 578
• 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.
• Keywords: TRIAL; IMMUNODEFICIENT CHILD; KI; Life Sciences & Biomedicine; PCV9; BURDEN; CONJUGATE; PNEUMONIA; HIV; Pneumococcal vaccine; WU; TRACT INFECTIONS; Science & Technology; Pneumonia; Virology; VIRUS; DISEASE; Polyomaviruses; Respiratory infections
• Research Categories: Biology, Virology; Health Sciences, Immunology

Abstract

Background: Two recently discovered polyomaviruses (PyV), WU and KI, have been identified in respiratory-tract specimens from children with acute respiratory infections, although there are limited data in HIV-infected children. Objectives: To determine the prevalence and clinical manifestations of WUPyV and KIPyV-associated lower respiratory tract infections (LRTIs) hospitalization in HIV-infected and -uninfected children; and probe the role of pneumococcal co-infection. Study design: Nasopharyngeal aspirates were collected from a cohort of 39,836 children randomized to receive 9-valent pneumococcal conjugate vaccine (PCV9) or placebo when hospitalized for LRTIs, and were screened by PCR for WUPyV, KIPyV and other respiratory viruses. Results: In placebo-recipients the prevalence of WUPyV was 6.3% (18/285) in HIV-infected and 13.9% (66/476) in HIV-uninfected children (p=. 0.002). In WUPyV-positive LRTIs HIV-infected children had lower oxygen saturation at admission and a higher case fatality rate (11.1% vs. 0%; p=. 0.04). KIPyV was identified in 10.2% (29/285) of HIV-infected and in 7.4% (35/476) of HIV-uninfected placebo-recipients with LRTIs (p=. 0.13). HIV-infected compared to HIV-uninfected children with KIPyV-positive LRTIs had lower oxygen saturation, higher respiratory rate and longer duration of hospitalization. Co-infections with other respiratory-viruses were detected in 65.5% of WUPyV-positive LRTIs and in 75.0% of KIPyV-positive LRTIs. Among HIV-uninfected children, there was a lower incidence of hospitalization for clinical pneumonia episodes in which KIPyV (80%; 95% CI: 41, 93) and WUPyV (49%; 95% CI: 9, 71) were identified among PCV9-recipients compared to placebo-recipients. Conclusions: Polyomaviruses were commonly identified in HIV-infected and -uninfected children hospitalized for LRTIs, frequently in association with other viruses and may contribute to the pathogenesis of pneumococcal pneumonia.