The impact of maternal HIV infection on the burden of respiratory syncytial virus among pregnant women and their infants, western Kenya

Bryan O Nyawanda, Nancy A Otieno, Michael O Otieno, Gideon O Emukule, Godfrey Bigogo, Clayton O Onyango, Shirley Lidechi, Jeremiah Nyaundi, Gayle E Langley, Marc-Alain Widdowson, Sandra S Chaves

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Abstract

BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of respiratory illness worldwide, however, burden data on mother-infant pairs remain sparse in sub-Saharan Africa where HIV is prevalent. We evaluated the impact of maternal HIV infection on the burden of RSV among mothers and their infants in western Kenya.

METHODS: We enrolled pregnant women (≤20 weeks gestation) and followed them and their newborns weekly for up to 3-6 months post-partum, to document cases of acute respiratory illness (ARI). Nasal/ oropharyngeal swabs were collected and tested for RSV using polymerase chain reaction. Analyses were stratified by maternal HIV-status, and incidence computed per 1,000 person-months.

RESULTS: Compared to RSV-negative ARI cases, RSV-positive cases were associated with cough, apnoea and hospitalization among infants. RSV incidence per 1,000 person-months among mothers was 4.0 (95% confidence interval (CI), 3.2-4.4), and was twice that among the HIV-infected (8.4; 95% CI, 5.7-12.0) compared to the HIV-uninfected mothers (3.1; 95% CI 2.3-4.0). Among infants, incidence per 1,000 person-months was 15.4 (95% CI, 12.5-18.8); incidence did not differ by HIV exposure or prematurity.

CONCLUSION: HIV-infection may increase the risk of RSV illness among pregnant women. Future maternal RSV vaccines may have added benefit in high HIV prevalence areas.

Original languageEnglish
JournalJournal of Infectious Diseases
Volume225
Issue number12
Pages (from-to)2097–2105
Number of pages9
ISSN0022-1899
DOIs
Publication statusPublished - 2022

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