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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Influenza-related mortality among adults aged 25-54 years with AIDS in South Africa and the United States of America
Clinical Infectious Diseases, Volume 55, No. 7, Year 2012
Notification
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Description
Background.Data are limited on human immunodeficiency virus (HIV)-associated influenza burden in sub-Saharan Africa and the impact of highly active antiretroviral therapy (HAART). We compared influenza-related mortality in adults with AIDS in South Africa and the United States in the pre-HAART era and evaluated mortality trends after HAART introduction in the United States.Methods.Monthly all-cause and pneumonia and influenza (P&I) mortality rates were compiled for adults with AIDS aged 25-54 years in South Africa (1998-2005) and the United States (pre-HAART era, 1987-1994; HAART era, 1997-2005). We estimated influenza-related deaths as excess mortality above a model baseline during influenza epidemic periods. Influenza-related mortality rates in adults with AIDS were compared with rates for age peers in the general population and adults ≥65 years old.Results.In the United States before HAART, influenza-related mortality rates in adults with AIDS were 150 (95 confidence interval [CI], 49-460) and 208 (95 CI, 74-583) times greater than in the general population for all-cause and P&I deaths, respectively, and 2.5 (95 CI, 0.9-7.2) and 4.1 (95 CI, 1.4-13) times higher than in elderly adults. After HAART introduction, influenza-related mortality in adults with AIDS dropped 3-6-fold but remained elevated compared with the general population (all-cause relative risk [RR], 44 [95 CI, 16-121]); P&I RR, 73 [95 CI, 47-113]). Influenza-related mortality in South African adults with AIDS in recent years was similar to that in the United States in the pre-HAART era.Conclusions.Adults with AIDS experience substantially elevated influenza-associated mortality, which declines with widespread HAART introduction but does not disappear. These data support increased access to HAART and influenza vaccination for HIV-infected adults. © The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Cohen, Cheryl D.
South Africa, Johannesburg
National Health Laboratory Service
South Africa, Cape Town
School of Public Health
Simonsen, Lone
United States, Bethesda
National Institutes of Health Nih
United States, Washington, D.c.
The George Washington University
Sample, Jeannette
United States, Washington, D.c.
The George Washington University
Kang, Jongwon
United States, Bethesda
National Institutes of Health Nih
South Korea, Cheongju
Chungbuk National University, College of Medicine
Miller, Mark A.
United States, Bethesda
National Institutes of Health Nih
Madhi, Shabir A.
South Africa, Johannesburg
University of the Witwatersrand
Campsmith, Michael L.
United States, Atlanta
Centers for Disease Control and Prevention
Viboud, Cécile G.
United States, Bethesda
National Institutes of Health Nih
Statistics
Citations: 71
Authors: 8
Affiliations: 7
Identifiers
Doi:
10.1093/cid/cis549
ISSN:
10584838
e-ISSN:
15376591
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
South Africa