Abstract
BackgroundPalivizumab prophylaxis for the human respiratory syncytial virus (HRSV) has been reported to reduce the risk of hospital admissions related to HRSV in children with congenital heart disease (CHD). These children are at high risk of developing severe lower respiratory tract infection (LRTI) due to HRSV infection. Our goal was to evaluate the incidence of HRSV infection in children with CHD after being submitted to immunoprophylaxis with palivizumab in Pará state, North region of Brazil.MethodsA prospective and observational cohort study was performed in children ≤2 years of age with CHD who received palivizumab immunoprophylaxis between January 1 and June 31, 2016. A questionnaire about basic non-medical care measures was applied to parents/legal representatives. Data on patients’ demographic characteristics, household environment, and respiratory infections were evaluated. HRSV infection was determined by qPCR.ResultsThere were 104 children enrolled in this investigation and the results showed a mean age of 10.6 months, an average weight of 7.3 kg and 3.5 doses of palivizumab per children during seasonality of HRSV. Respiratory infection was observed in 27.9% of cases, of which 9.6% were LRTI. No case of children who received palivizumab immunoprophylaxis and developed influenza-like symptoms tested positive for HRSV.ConclusionAlthough the lack of a control group doesn’t allow to affirm the effectiveness of HRSV passive immunization, the immunoprophylaxis with palivizumab appeared to be totally efficient in preventing respiratory infection by HRSV in children up to two years of age with CHD.
Highlights
Palivizumab prophylaxis for the human respiratory syncytial virus (HRSV) has been reported to reduce the risk of hospital admissions related to HRSV in children with congenital heart disease (CHD)
This study investigated the knowledge of children’s parents/legal representatives regarding basic non-medical care measures to reduce HRSV transmission; the efficiency of the palivizumab program and its recommended monthly doses; and analysed the incidence of respiratory infections caused by HRSV in children after palivizumab immunization in a specialized reference hospital in cardiology in Belém, Brazil
Population studied and ethical aspects This was a prospective observational cohort study involving children with CHD who were participating of the palivizumab program attending various sectors of the Gaspar Vianna Public Foundation Hospital (FHCGV)
Summary
Palivizumab prophylaxis for the human respiratory syncytial virus (HRSV) has been reported to reduce the risk of hospital admissions related to HRSV in children with congenital heart disease (CHD). HRSV infections occur predominantly in well-defined seasons, usually during autumn and winter, and in temperate and subtropical regions. These seasons last between 16 to 20 weeks annually [5, 6] and often matches with the seasonality of the influenza virus [7]. The prevalence of HRSV infection in Brazil is derived from the data of the Influenza Sentinel Surveillance Information System and other respiratory viruses (SIVEP-FLIPE) It was based on data from influenza-like reports of illness during the period of 2007 to 2014. The Ministry of Health (Joint Technical Note no. 05/2015) defined the regional seasonality of HRSV infection in different regions in Brazil, which in the North region corresponds to the period from January to June [8]
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