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Volume 19, Number 11—November 2013
Research

Severe Influenza-associated Respiratory Infection in High HIV Prevalence Setting, South Africa, 2009–2011

Cheryl CohenComments to Author , Jocelyn Moyes, Stefano Tempia, Michelle Groom, Sibongile Walaza, Marthi Pretorius, Halima Dawood, Meera Chhagan, Summaya Haffejee, Ebrahim Variava, Kathleen Kahn, Akhona Tshangela, Anne von Gottberg, Nicole Wolter, Adam L. Cohen, Babatyi Kgokong, Marietjie Venter, and Shabir A. Madhi
Author affiliations: National Health Laboratory Service, Johannesburg, South Africa (C. Cohen, J. Moyes, S. Walaza, M. Pretorius, A. Tshangela, A. von Gottberg, N. Wolter, B. Kgokong, M. Venter, S.A. Madhi); University of the Witwatersrand, Johannesburg (C. Cohen, J. Moyes, M. Groom, E. Variava, K. Kahn, A. von Gottberg, N. Wolter, S. A. Madhi); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Tempia, A.L. Cohen); Centers for Disease Control and Prevention–South Africa, Pretoria, South Africa (S. Tempia, A. L. Cohen); University of KwaZulu-Natal, Durban, South Africa (H. Dawood, M. Chhagan, S. Haffejee); Pietermaritzburg Metropolitan Hospital, Pietermaritzburg, South Africa (H. Dawood); Klerksdorp Tshepong Hospital, Klerksdorp, South Africa (E. Variava); Umeå University, Umeå, Sweden (K. Kahn); INDEPTH Network, Accra, Ghana (K. Kahn); University of Pretoria, Pretoria (M. Venter)

Main Article

Table 1

Incidence of laboratory-confirmed influenza-associated lower respiratory tract infection hospitalizations per 100,000 population by year and HIV status at Chris Hani-Baragwanath Hospital, South Africa*

Year and patient age range, y No. HIV-positive/no. tested (%) % HIV prevalence Incidence rate (95% CI)
 Relative risk (95% CI)
All patients HIV infected patients HIV uninfected patients HIV infected vs. uninfected Sensitivity analysis†
2009
0–4 103/188 (55) 11 336 (304–370) 766 (553–1,021) 314 (284–349) 2.4 (1.7–3.3) 1.3 (0.8–1.9)
5–24 18/29 (62) 39 27 (23–33) 194 (142–261) 17 (14–22) 11.0 (7.4–16.1) 5.5 (3.5–8.5)
25–44 41/44 (93) 88 59 (52–67) 198 (173–227) 9 (7–14) 20.3 (13.8–31.3) 12.7 (9–17.9)
≥45 27/27 (100) 41 67 (57–78) 260 (201–331) 44 (36–54) 5.9 (4.2–8.2) 5.9 (4.2–8.2)
Total
 189/288 (66)
 34
 78 (73–83)
 228 (206–254)
 54 (50–60)
4.2 (3.6–4.8)‡
 3.3 (2.9–3.8)‡
2010
0–4 54/84 (64) 9 153 (131–177) 317 (187–514) 145 (124–170) 2.2 (1.3–3.6) 1.4 (0.7–2.5)
5–24 15/22 (68) 33 14 (11–18) 89 (57–135) 10 (7–13) 8.8 (5.2–15.2) 5.2 (2.8–9.5)
25–44 73/78 (94) 89 60 (53–68) 203 (178–231) 9 (6–13) 22.9 (15.4–34.7) 14.1 (10.1–19.8)
≥45 38–39 (97) 55 47 (40–56) 243 (191–307) 24 (18–31) 10.3 (7.2–14.8) 9.7 (6.8–13.9)
Total
 180/223 (81)
 53
 49 (45–53)
 197 (176–219)
 26 (23–29)
7.5 (6.4–8.8)‡
 6.2 (5.3–7.3)‡
2011
0–4 81/96 (84) 6 186 (162–212) 273 (151–463) 182 (159–209) 1.5 (0.8–2.6) 1.3 (0.6–2.3)
5–24 13/13 (100) 46 8 (6–11) 71 (42–111) 5 (3–7) 15.4 (7.7–30.3) 15.4 (7.7–30.3)
25–44 88/89 (99) 80 68 (61–76) 206 (180–234) 19 (15–24) 10.9 (8.2–14.7) 10.4 (7.9–14)
≥45 42/43 (98) 38 56 (48–65) 192 (146–247) 39 (32–48) 4.9 (3.5–6.9) 4.8 (3.4–6.7)
Total 224/241 (93) 43 54 (50–58) 186 (167–207) 34 (31–37) 5.5 (4.7–6.3)‡ 5.3 (4.6–6.2)‡

*Boldface indicates significance.
†Assuming that all patients not tested for HIV are HIV negative.
‡Age-adjusted.

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Page created: October 31, 2013
Page updated: October 31, 2013
Page reviewed: October 31, 2013
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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