Association between HIV and proven viral lower respiratory tract infection in paediatric intensive care unit patients at Inkosi Albert Luthuli Central Hospital, Durban, South Africa

Abstract

Background. Acute viral respiratory infections are common within the paediatric population. Nucleic acid amplification tests can identify a wide range of respiratory viruses. Virally infected patients can now be diagnosed early and more accurately in the acute phase of illness.

Objectives. To examine the association between HIV status and mortality in children with viral lower respiratory tract infection (LRTI) and to delineate the profile of identified viruses.

Methods. We conducted a retrospective review of charts of children aged from birth to 10 years of age who were admitted to the paediatric intensive care unit at Inkosi Albert Luthuli Central Hospital with a viral LRTI between December 2010 and May 2015. Only patients who had a positive respiratory viral multiplex test were eligible for entry into the study. Patients were grouped according to their HIV status and mortality was assessed.

Results. A total of 338 records were analysed in this study. Sixty-five patients tested HIV-positive (19.2%) and 80.8% were HIV-negative (n=273). There were 55 mortalities: 12 were among the 65 HIV-positive patients (18.5%) and 43 among the 273 HIV-negative patients (15.8%). The difference in mortality according to HIV status was not statistically significant (p=0.595). Respiratory syncytial virus was the most prevalent virus identified overall, with adenovirus being most prevalent in the HIV-positive group.

Conclusion. The results showed that patients with viral LRTIs who required respiratory support had a similar mortality regardless of HIV status.