期刊
INFLUENZA AND OTHER RESPIRATORY VIRUSES
卷 7, 期 6, 页码 1079-1087出版社
WILEY
DOI: 10.1111/irv.12020
关键词
Co-infection; dual or multiple infections; influenza A viruses; Influenza B virus; respiratory virus infections
Introduction Recent literature suggests that dual or multiple virus infections may affect disease severity. However, few studies have investigated the effect of co-infection with influenza A viruses. Objectives To identify the association between influenza A and respiratory viruses co-infections with disease outcome. Methodology Data for samples from North West England tested between January 2007 and June 2011 was analysed for patterns of co-infection between influenza A viruses and eight respiratory viruses. Risk of hospitalisation to ICU or general ward in single versus co-infections was assessed using logistic regression. Results Of the 25 596 samples analysed for respiratory viruses 40.7% (10 501) were positive for any virus. Co-infections were detected in 4.7% (137/2879) of all patients with influenza A(H1N1) pdm09, and 7.3% (57/779) of those with other influenza A virus infections. Co-infection between seasonal influenza A viruses and influenza B virus was associated with a significant increase in the risk of admission to ICU/death (OR: 22.0, 95% CI: 2.21-219.8, P = 0.008). Respiratory syncytial virus/influenza A (RSV/Flu A) co-infection also increased this risk but was not statistically significant. For influenza A(H1N1) pdm09, RSV and AdV co-infection increased risk of hospitalisation to general ward whereas Flu B increased risk of admission to ICU, but none of these were statistically significant. Conclusion Co-infection is a significant predictor of disease outcome; combined treatment, introduction of an integrated vaccine for all respiratory viruses and development of multi-target rapid diagnostic tests is recommended. Integration of respiratory viruses' co-infections into public health reports could also contribute to the accumulation of evidence.
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