Rhinovirus Infection and Familial Atopy Predict Persistent Asthma and Sensitisation 7 Years after a First Episode of Acute Bronchiolitis in Infancy.

Julie Magnier,Aurélien Mulliez,Emmanuelle Rochette,Carole Egron,Flore Amat,Bertrand Evrard,Valérie Julian,Alexandra Usclade

doi:10.3390/children8100850

Abstract

Background: We set out to assess the risk factors for asthma outcome in a cohort of infants who experienced their first episode of acute bronchiolitis. Methods: A cohort of 222 infants who were included during a first episode of acute bronchiolitis was prospectively followed. Herein, we present the results of their assessments (symptom history, skin prick tests, specific IgE assay, respiratory function tests) at age seven. Results: Of the 68/222 (30.6%) children assessed at age seven, 15 (22.05%) presented with asthma and were mainly males (p = 0.033), 14 (20%) had respiratory allergies, 17 (25%) presented atopic dermatitis and none had a food allergy. Family history of atopy was associated with asthma and sensitisation to aeroallergens at age seven (p = 0.003, p = 0.007). Rhinovirus (hRV) infection and rhinovirus/respiratory syncytial virus (RSV) co-infection were significantly associated with asthma at age seven (p = 0.035, p = 0.04), but not with the initial severity of bronchiolitis. Eosinophil counts at ages three and seven were significantly higher in the asthmatics (p = 0.01, p = 0.046). Conclusion: Any infant, especially male, presenting a first episode of acute bronchiolitis due to hRV with a family history of atopy should be closely monitored via follow-up due to a higher risk for asthma at school age.

Highlights

Acute bronchiolitis is the most common cause of lower respiratory tract infections in the first year of life
The children who were lost to follow-up (Table 1) did not differ significantly from those assessed at age seven in terms of sex, gestational age at birth, family history of asthma, passive tobacco smoking, initial severity of bronchiolitis and initial care for acute bronchiolitis
We found a asthma development rate of 22%, which is comparable to the few other cohorts available of infants hospitalised for acute bronchiolitis (15–34%) [8,19,20]

Summary

Introduction

Acute bronchiolitis is the most common cause of lower respiratory tract infections in the first year of life. The viruses that are mainly responsible are the respiratory syncytial virus (RSV), which is associated with a more severe disease, and the rhinovirus (hRV), which is associated with more moderate forms of disease but a higher risk of asthma during childhood [1,2]. We set out to assess the risk factors for asthma outcome in a cohort of infants who experienced their first episode of acute bronchiolitis. Rhinovirus (hRV) infection and rhinovirus/respiratory syncytial virus (RSV) co-infection were significantly associated with asthma at age seven (p = 0.035, p = 0.04), but not with the initial severity of bronchiolitis. Conclusion: Any infant, especially male, presenting a first episode of acute bronchiolitis due to hRV with a family history of atopy should be closely monitored via follow-up due to a higher risk for asthma at school age

Methods

Results

Discussion

Conclusion