Volume 21, Number 4—April 2015
CME ACTIVITY - Research
Deaths Associated with Respiratory Syncytial and Influenza Viruses among Persons ≥5 Years of Age in HIV-Prevalent Area, South Africa, 1998–20091
Cheryl Cohen
, Sibongile Walaza, Cecile Viboud, Adam L. Cohen, Shabir A. Madhi, Marietjie Venter, Claire von Mollendorf, Jocelyn Moyes, Johanna M. McAnerney, and Stefano Tempia
, Sibongile Walaza, Cecile Viboud, Adam L. Cohen, Shabir A. Madhi, Marietjie Venter, Claire von Mollendorf, Jocelyn Moyes, Johanna M. McAnerney, and Stefano Tempia
Table 1
Seasonal influenza virus mean annual excess deaths and relative risk for death related to HIV infection among persons ≥5 y of age, South Africa, 1998–2009*
| Cause of death by age, y | Mean annual excess deaths (95% CI) |
Relative risk, HIV+ vs HIV– (95% CI) | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Total |
HIV+ |
HIV– |
||||||||
| No., mean | Rate,† mean | % Death over model baseline | No., mean | Rate,† mean | No., mean | Rate,† mean | ||||
| All causes | ||||||||||
| 5–19 | 127 (91–171) | 0.8 (0.6–1.1) | 2.4 (2.0–2.7) | 52 (37–70) | 23.6 (16.9–31.8) | 75 (53–101) | 0.5 (0.3–0.7) | 46.6 (20.9–104.3) | ||
| 20–44 | 1,966 (1,160–2,770) | 10.7 (6.3–15.1) | 3.0 (2.9–3.2) | 1,851 (1,074–2,567) | 56.3 (33.1–78.2) | 114 (86–203) | 0.7 (0.6–1.3) | 72.8 (38.1–138.9) | ||
| 45–64 | 2,447 (1,499–3,408) | 37.3 (23.0–52.0) | 5.7 (5.5–5.8) | 661 (400–920) | 163.9 (101.6–228.2) | 1,785 (1,098–2,488) | 29.3 (18.1–40.9) | 5.6 (5.0–6.2) | ||
| 65–74 | 1,664 (1,185–2,181) | 115.4 (82.5–151.3) | 8.1 (7.8–8.6) | NED | NED | 1,664 (1,185–2,181) | 115.4 (82.5–151.3) | NA | ||
| ≥75 | 2,888 (2,138–3,557) | 379.2 (281.1–467.1) | 10.7 (10.2–11.7) | NED | NED | 2,888 (2,138–3,557) | 379.2 (281.1–467.1) | NA | ||
| ≥5 |
9,093 (6,073–12,087) |
21.6 (15.7–28.9) |
5.7 (5.5–6.1) |
2,564 (1,511–3,557) |
64.7 (38.3–81.1) |
7,189 (4,560–8,530) |
18.9 (12.5–24.3) |
7.9 (7.1–8.9)‡ |
||
| All respiratory | ||||||||||
| 5–19 | 96 (60–137) | 0.6 (0.4–0.9) | 9.8 (8.9–10.2) | 55 (24–79) | 24.6 (15.3–32.7) | 41 (27–60) | 0.3 (0.2–0.4) | 87.7 (30.0–157.3) | ||
| 20–44 | 778 (416–1,144) | 4.2 (2.3–6.2) | 5.0 (4.7–5.2) | 722 (386–1061) | 21.5 (11.6–31.7) | 56 (30–82) | 0.4 (0.2–0.6) | 57.1 (22.5–143.4) | ||
| 45–64 | 1,106 (696–1,562) | 16.8 (10.6–23.8) | 11.4 (11.0–11.7) | 380 (237–536) | 93.9 (59.9–132.7) | 725 (459–1,025) | 11.9 (7.6–16.8) | 7.9 (6.6–9.4) | ||
| 65–74 | 626 (416–852) | 43.4 (28.9–59.1) | 14.3 (13.7–15.1) | NED | NED | 626 (416–852) | 43.4 (28.9–59.1) | NA | ||
| ≥75 | 1,005 (704–1,323) | 132.3 (92.9–174.2) | 17.3 (16.8–21.4) | NED | NED | 1,005 (704–1,323) | 132.3 (92.9–174.2) | NA | ||
| ≥5 |
3,613 (2,292–5,018) |
8.5 (5.8–11.2) |
10.0 (9.6–10.8) |
1157 (647–1,676) |
28.7 (17.1–38.8) |
2,455 (1,636–3,342) |
6.4 (4.8–8.2) |
11.1 (9.4–13.1)‡ |
||
| All circulatory | ||||||||||
| 5–19 | 28 (7–48) | 0.2 (0.05–0.3) | 6.2 (5.8–6.9) | NED | NED | 28 (7–48) | 0.2 (0.05–0.3) | NA | ||
| 20–44 | 252 (127–375) | 1.4 (0.7–2.0) | 4.0 (3.5–4.7) | 226 (120–332) | 7.2 (3.8–10.6) | 26 (14–36) | 0.2 (0.1–0.3) | 41.2 (15.3–123.7) | ||
| 45–64 | 854 (619–1,081) | 13.2 (9.6–16.7) | 6.9 (5.9–7.3) | 258 (116–400) | 66.3 (29.8–102.8) | 596 (322–870) | 9.9 (5.3–14.4) | 6.6 (3.3–9.9) | ||
| 65–74 | 749 (536–955) | 52.1 (37.3–66.4) | 8.3 (7.8–8.9) | NED | NED | 749 (536–955) | 52.1 (37.3–66.4) | NA | ||
| ≥75 | 1,270 (971–1,511) | 167.4 (128.2–199.2) | 10.1 (9.3–11.1) | NED | NED | 1,270 (971–1,511) | 167.4 (128.2–199.2) | NA | ||
| ≥5 |
3,153 (2,260–3,970) |
7.5 (5.8–12.3) |
7.8 (7.1–8.7) |
484 (236–732) |
12.0 (5.8–18.2) |
2,669 (1,859–3,420) |
6.9 (4.8–8.9) |
6.8 (3.1–10.5)‡ |
||
| Pneumonia and influenza | ||||||||||
| 5–19 | 86 (55–120) | 0.6 (0.4–0.8) | 13.7 (11.9–15.6) | 50 (31–69) | 22.4 (14.4–31.3) | 36 (23–51) | 0.2 (0.1–0.3) | 91.1 (28.9–186.7) | ||
| 20–44 | 569 (317–823) | 3.1 (1.7–4.5) | 5.4 (4.9–6.1) | 522 (290–754) | 15.5 (8.7–22.5) | 47 (26–68) | 0.3 (0.2–0.4) | 48.5 (17.6–133.1) | ||
| 45–64 | 612 (378–923) | 9.3 (5.7–13.9) | 12.5 (11.1–13.4) | 279 (169–415) | 67.1 (42.0–101.1) | 336 (209–507) | 5.5 (3.4–8.3) | 12.2 (9.4–15.6) | ||
| 65–74 | 299 (179–430) | 20.8 (12.5–29.8) | 16.1 (15.3–17.5) | NED | NED | 299 (179–430) | 20.8 (12.5–29.8) | NA | ||
| ≥75 | 620 (438–870) | 83.0 (57.8–114.6) | 21.2 (19.4–24.6) | NED | NED | 620 (438–870) | 83.0 (57.8–114.6) | NA | ||
| ≥5 | 2,186 (1,367–3,166) | 5.2 (2.4–6.1) | 10.8 (8.7–12.2) | 848 (490–1,238) | 20.9 (13.8–28.1) | 1,341 (875–1,926) | 3.5 (2.1–5.7) | 17.3 (13.6–21.8)‡ | ||
*Estimated from model 1 (excess deaths irrespective of HIV status) and model 2 (excess deaths by HIV status). HIV, human immunodeficiency virus; NED, no estimated deaths; NA, not applicable.
†Mortality rates per 100,000 person-years.
‡Age-adjusted relative risk.
1Data from this study were presented in part at the Options for the Control of Influenza Conference VIII; 2013 Sep 5–10; Cape Town, South Africa.
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