Association of RSV-A ON1 genotype with Increased Pediatric Acute Lower Respiratory Tract Infection in Vietnam

Keisuke Yoshihara,Hien Anh Nguyen,Hitoshi Oshitani,Duc Anh Dang,Masahiro Hashizume,Michiko Okamoto,Lay-Myint Yoshida,Anita Carolle Akpeedje Wadagni,Motoi Suzuki,Ai Thi Thuy Nguyen,Minh Nhat Le,Michiko Toizumi,Koya Ariyoshi,Hiroyuki Moriuchi,Enga Pham

doi:10.1038/srep27856

Abstract

Since the initial discovery of RSV-A ON1 in Canada in 2010, ON1 has been reported worldwide, yet information regarding its clinical impact and severity has been controversial. To investigate the clinical relevance of RSV-A ON1,acute respiratory infection (ARI) cases enrolled to our population-based prospective pediatric ARI surveillance at Khanh Hoa General Hospital, Central Vietnam from January 2010 through December 2012 were studied. Clinical-epidemiological information and nasopharyngeal samples were collected. Multiplex PCR assays were performed for screening 13 respiratory viruses. RSV-positive samples were further tested for subgroups (A/B) and genotypes information by sequencing the G-glycoprotein 2nd hypervariable region. Statistical analysis was performed to evaluate the clinical-epidemiological characteristics of RSV-A ON1. A total of 1854 ARI cases were enrolled and 426 (23.0%) of them were RSV-positive. During the study period, RSV-A and B had been co-circulating. NA1 was the predominant RSV-A genotype until the appearance of ON1 in 2012. RSV-related ARI hospitalization incidence significantly increased after the emergence of ON1. Moreover, multivariate analysis revealed that risk of lower respiratory tract infection was 2.26 (95% CI: 1.37–3.72) times, and radiologically-confirmed pneumonia was 1.98 (95% CI: 1.01–3.87) times greater in ON1 compared to NA1 cases. Our result suggested that ON1 ARI cases were clinically more severe than NA1.

Highlights

Human Respiratory Syncytial Virus (RSV) is a pneumovirus under the family of paramyxoviridae with a negative-sense single stranded RNA genome[1]
A total of 1854 hospitalized acute respiratory infection (ARI) cases were enrolled into our population-based pediatric Acute Respiratory Infection (ARI) surveillance at Khanh Hoa General Hospital (KHGH) during the three years study period
Our current study highlights the clinical importance of RSV among the pediatric ARI cases in Central Vietnam

Summary

Introduction

Human Respiratory Syncytial Virus (RSV) is a pneumovirus under the family of paramyxoviridae with a negative-sense single stranded RNA genome[1]. Our population-based ARI surveillance in Central Vietnam reported that RSV was one of the main viral pathogens among hospitalized ARI children less than 2 years of age[4]. To gain a better understanding of the association of RSV subgroup and genotype with clinical outcome, it is essential to further expand RSV molecular epidemiological surveillance worldwide. There is still limited information regarding the molecular and clinical epidemiological characteristics of RSV in South East Asian nations including Vietnam. In this study, we investigated the annual incidence of RSV-related pediatric ARI hospitalization, circulation dynamics of RSV subgroups (A/B) and genotypes, and the clinical significance of RSV-A ON1 genotype among the hospitalized pediatric ARI cases in Central Vietnam

Methods

Results

Discussion

Conclusion