Key result
Rhinovirus detection was associated with a substantial proportion of clinical illness, with an attributable fraction of 54.6% for influenza-like illness and 51.4% for severe respiratory illness, irrespective of HIV status.
Why the study?
The association of rhinovirus detection with respiratory illness is poorly understood.
Is rhinovirus detection associated with mild and severe respiratory illness in a setting of high HIV prevalence?
Observational (n=10,134)
Yes
Is rhinovirus detection associated with mild and severe respiratory illness in a setting of high HIV prevalence?
Effect estimate: AF 54.6% (95% CI 47.5%-60.8%)
Absolute Event Rate: 26.8% vs 17.4%
p-value: p=<0.001
Despite frequent asymptomatic detection, rhinovirus is associated with a substantial proportion of mild and severe respiratory illness across age groups, irrespective of HIV status.
RV detection was associated with substantial ILI/SRI burden across HIV strata; leaves open questions on causality and testing thresholds in high-prevalence settings.
BACKGROUND: The association of rhinovirus (RV) detection to illness is poorly understood. METHODS: We enrolled case patients hospitalized with severe respiratory illness (SRI) at 2 hospitals and outpatients with influenza-like illness (ILI) and asymptomatic individuals (controls) from 2 affiliated clinics during 2013-2015. We compared the RV prevalence among ILI and SRI cases to those of controls stratified by human immunodeficiency virus (HIV) serostatus using penalized logistic regression. The attributable fraction (AF) was calculated. RESULTS: During 2013-2015, RV was detected in 17.4% (368/2120), 26.8% (979/3654), and 23.0% (1003/4360) of controls, ILI cases, and SRI cases, respectively. The RV AF (95% confidence interval) was statistically significant among children aged <5 years (ILI: 44.6% [30.7%-55.7%] and SRI: 50.3% [38.6%-59.9%]; P < .001) and individuals aged ≥5 years (ILI: 62.9% [54.4%-69.8%] and SRI: 51.3% [38.7%-61.3%]; P < .001) as well as among HIV-infected (ILI: 59.9% [45.8%-70.3%] and SRI: 39.8% [22.3%-53.3%]; P < .001) and HIV-uninfected (ILI: 53.6% [44.7%-61.1%] and SRI: 55.3% [45.6%-63.2%]; P < .001) individuals. CONCLUSIONS: Although RV detection was common among controls, it was also associated with a substantial proportion of clinical illness across age groups, irrespective of HIV status.
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Hellferscee et al. (2018) conducted an observational in Severe respiratory illness and influenza-like illness (n=10,134). Rhinovirus infection vs. Asymptomatic controls was evaluated on Rhinovirus attributable fraction (RV-AF) for influenza-like illness (AF 54.6%, 95% CI 47.5%-60.8%, p=<0.001). Rhinovirus detection was associated with a substantial proportion of clinical illness, with an attributable fraction of 54.6% for influenza-like illness and 51.4% for severe respiratory illness, irrespective of HIV status.
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