Madhi Shabir A, Ludewick Herbert, Kuwanda Locadiah, van Niekerk Nadia, Cutland Clare, Klugman Keith P
University of the Witwatersrand/Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, Chris Hani-Baragwanath Hospital, Bertsham, South Africa.
Pediatr Infect Dis J. 2007 Aug;26(8):693-9. doi: 10.1097/INF.0b013e3180621192.
There is limited information regarding the epidemiology of human metapneumovirus (hMPV) from Africa, despite it being identified as a common pathogen in children with pneumonia.
Determine the epidemiology of severe hMPV-associated lower respiratory tract infection (LRTI) in human immunodeficiency virus type-1 (HIV) infected and uninfected children.
Nasopharyngeal aspirate samples from children hospitalized for LRTI between January 2000 and December 2002 were analyzed for common respiratory viruses using an immunofluorescence assay; and 2715 available nasopharyngeal aspirate samples were tested for hMPV by reverse-transcriptase polymerase chain reaction targeting its fusion protein. Phylogenetic analysis of the fusion (F) gene was performed on samples associated with repeat hMPV infections in the same child.
hMPV was identified perennially and was the second most commonly identified respiratory virus (11.3% versus 21.1% for respiratory syncytial virus, P < 0.0001) in HIV-uninfected children. The burden of hospitalization for hMPV-LRTI was 5.4 (95% CI: 3.5-7.5) fold greater in HIV-infected (2935 per 100,000) compared with HIV-uninfected children [575 (95% CI: 472-695) per 100,000]. HIV-infected children had greater evidence of bacterial coinfection and a higher mortality rate than did uninfected children. Repeat hMPV associated hospitalizations involved homologous (B2 subgroup) and heterologous (A1 and B2) hMPV.
There is a high burden of hMPV-LRTI and repeat severe infections occur from homologous and heterologous subgroups of the virus.
尽管人偏肺病毒（hMPV）已被确定为肺炎患儿的常见病原体，但来自非洲的关于其流行病学的信息有限。
确定1型人类免疫缺陷病毒（HIV）感染和未感染儿童中严重hMPV相关下呼吸道感染（LRTI）的流行病学特征。
对2000年1月至2002年12月因LRTI住院的儿童的鼻咽抽吸物样本，使用免疫荧光测定法分析常见呼吸道病毒；并通过针对其融合蛋白的逆转录聚合酶链反应，对2715份可用的鼻咽抽吸物样本进行hMPV检测。对同一儿童中与hMPV重复感染相关的样本进行融合（F）基因的系统发育分析。
hMPV全年均可检出，在未感染HIV的儿童中是第二常见的呼吸道病毒（11.3%，呼吸道合胞病毒为21.1%，P<0.0001）。与未感染HIV的儿童[每100,000人中有575例（95%CI：472-695）]相比，HIV感染儿童[每100,000人中有2935例（95%CI：3.5-7.5）]因hMPV-LRTI住院的负担要高5.4倍。与未感染儿童相比，HIV感染儿童有更多细菌合并感染的证据，且死亡率更高。hMPV相关的重复住院涉及同源（B2亚组）和异源（A1和B2）hMPV。
hMPV-LRTI负担很高，且该病毒的同源和异源亚组都会发生重复的严重感染。
