Abstract
Several species of the genus Enterovirus cause persistent infections in humans. Human rhinovirus (HRV) infections are generally self-limiting but occasionally persistent infections have been described. This study aimed to identify persistent HRV infections and investigate the clinical and virologic characteristics of patients with persistent infections. From January 2012 to March 2015, 3714 respiratory specimens from 2608 patients were tested for respiratory viruses by using a multiplex reverse transcription–polymerase chain reaction. A retrospective study was performed. Patients with at least two specimens positive for HRV/enterovirus taken 45 days or longer apart were identified and the HRV/enteroviruses were typed. Patients with persistent infection were compared to patients with reinfection and patients with cleared infection. Phylogenetic analysis of the viral protein(VP)4/VP2 region was performed. 18 patients with persistent HRV/enterovirus infection were identified. Minimum median duration of persistence was 92 days (range 50–455 days). All but one patients with persistence were immunosuppressed. Immunosuppression and hematologic disorders were more frequent in patients with persistence (n = 18) than in patients with reinfection (n = 33) and with cleared infection (n = 25) (p = 0.003 and p = 0.001, respectively). In conclusion, this retrospective study identified HRV persistence in vivo which occurred mainly in immunosuppressed patients.
Highlights
Human rhinoviruses (HRV) are classified into three species (A, B and C) within the genus Enterovirus of the family Picornaviridae [1,2]
111 patients had 2 or more specimens that were tested positive for HRV/enterovirus (HRV++), 74 patients had a specimen that tested positive for HRV/enterovirus followed by a specimen that tested negative for HRV/enterovirus (HRV+-), 46 patients had a specimen that tested negative for HRV/enterovirus followed by a specimen that tested positive for HRV/enterovirus (HRV-+) and in 334 patients all specimens were tested negative for HRV/enterovirus (HRV--) (Fig 1)
Of the 111 patients that had 2 or more specimens that tested positive for HRV/enterovirus (HRV++), 55 patients had repeated detection of HRV/enterovirus in respiratory specimens taken at least 45 days apart
Summary
Human rhinoviruses (HRV) are classified into three species (A, B and C) within the genus Enterovirus of the family Picornaviridae [1,2]. HRVs mainly cause upper respiratory tract infections. They can cause lower respiratory infection and are associated with exacerbations of chronic pulmonary diseases [3], such as asthma [4], chronic obstructive pulmonary disease [5] and cystic fibrosis [2,6]
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