Human Metapneumovirus Infection in HIV Patients

Winslow, Dean L.
April 2010
Infectious Disease Alert;Apr2010, Vol. 29 Issue 7, p74
Fifty consecutive patients from a large HIV clinic in Montreal, who presented with febrile respiratory symptoms (temperature > 38° C and one or more respiratory symptom) from November 2003-April 2006, were recruited for this prospective study. An in-house multiplex realtime PCR assay was originally used to test NP samples for influenza A and B, RSV, and hMPV. Frozen aliquots of the original samples were later tested for adenovirus groups A, B, C, and E; rhinovirus A and B; influenza A and B, hMPV A and B; RSV A and B; parainfluenza types 1-3; coronaviruses HKU1, 229E, NL63, and OC43; and enteroviruses A-D using a commercial microarray assay. Paired acute and convalescent sera were analyzed by complement fixation. NP samples were tested for rRNA genes of M. pneumoniae, C. pneumoniae, and L. pneumophila. From all individuals with productive cough, a sputum sample was sent for bacterial culture and sensitivity. Twenty-two patients were found to be infected with influenza virus, 12 with noninfluenza viral pathogens, six had bacterial infections, and 16 were not diagnosed. Patients with influenza had a median CD4+ lymphocyte count of 280, and those with noninfluenza viral infections had a median CD4+ count of 484. In addition to fever and myalgias, the patients with hMPV infection had predominant lower respiratory tract symptoms, with cough, dyspnea, and wheezing in most cases. Only one of the hMPV cases was complicated by documented bacterial infection (bacteremic pneumococcal disease). While the hMPV patients were less immunosuppressed than the influenza patients, almost all had underlying asthma.


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