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J Infect Dis. 2018 Dec 12. doi: 10.1093/infdis/jiy702. [Epub ahead of print]

Household transmission of seasonal influenza from HIV-infected and -uninfected individuals in South Africa, 2013-2014.

Author information

1
Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
2
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
3
Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
4
District of Columbia Department of Health, Washington, DC, USA.
5
School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
6
Centre for Viral Zoonoses, Department of Medical Virology, University of Pretoria.
7
Perinatal HIV Research Unit (PHRU), Klerksdorp-Tshepong Hospital, North West Province, South Africa.
8
Pietermaritzburg Metropolitan, KwaZulu-Natal, South Africa.
9
Influenza Division, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America (USA).
10
Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.
11
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
12
Expanded Programme on Immunization, Department of Immunizations, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland.

Abstract

Background:

Differential transmission from HIV-infected compared to HIV-uninfected individuals may impact influenza burden. We estimated the household secondary infection risk (SIR) and serial interval (SI) for influenza transmission from HIV-infected and HIV-uninfected index cases and identified associated factors.

Methods:

Index cases were the first symptomatic person in a household with influenza-like illness, testing influenza positive on real-time reverse transcription polymerase chain reaction (rRT-PCR). Nasopharyngeal swabs collected from household contacts every four days were tested by rRT-PCR. Factors associated with SIR were evaluated using logistic regression.

Results:

We enrolled 28 HIV-infected and 57 HIV-uninfected index cases. On multivariable analysis, HIV-infected index cases were less likely to transmit influenza to household contacts (odds ratio (OR) 0.2 95% CI 0.1-0.6)(SIR 16%, 18/113 vs 27%, 59/220). Factors associated with increased SIR included index age group 1-4 years (OR 3.6, 95% CI 1.2-11.3) and 25-44 years (OR 8.0, 95% CI 1.8-36.7) and contact age group 1-4 years (OR 3.5, 95%CI 1.2-10.3) compared to 5-14 years and sleeping with index case (OR 2.7, 95%CI 1.3-5.5). HIV-infection of index case was not associated with SI.

Conclusions:

HIV-infection was not associated with SI. Increased infectiousness of HIV-infected individuals is likely not an important driver of community influenza transmission.

PMID:
30541140
DOI:
10.1093/infdis/jiy702

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