Viral pathogens including human metapneumovirus are the primary cause of febrile respiratory illness in HIV-infected adults receiving antiretroviral therapy

J Infect Dis. 2010 Jan 15;201(2):297-301. doi: 10.1086/649587.


To determine the spectrum of pathogens causing acute febrile respiratory illness in human immunodeficiency virus (HIV)-infected adults, we re-analyzed data from a prospective surveillance study involving 50 outpatients (90% of whom received highly active antiretroviral therapy). Nasopharyngeal samples were tested for 23 respiratory viruses by multiplex reverse-transcriptase polymerase chain reaction (PCR) and for atypical bacteria by PCR. Sputum cultures and serological testing were performed. Viruses accounted for 64% of infections. After influenza (22 cases), human metapneumovirus infection (6 cases) was most common and was associated with bronchospasm. Bacterial infections occurred in 6 patients (3 of whom had concurrent viral infection). Over 80% of patients received antibiotics. Rapid testing to identify specific viral pathogens could aid in patient management and reduce unnecessary antibiotic exposure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections
  • Adult
  • Antiretroviral Therapy, Highly Active
  • Female
  • Fever / virology*
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Humans
  • Incidence
  • Male
  • Metapneumovirus*
  • Middle Aged
  • Outpatients
  • Paramyxoviridae Infections / complications*
  • Paramyxoviridae Infections / epidemiology
  • Population Surveillance*
  • Prospective Studies
  • Quebec / epidemiology
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / virology*
  • Young Adult