Risk of respiratory viral infections after hematopoietic stem cell transplantation in Indian patients

Abstract

Haematopoietic stem cell transplant (HSCT) recipients are at higher risk of morbidity and mortality due to respiratory infections and their frequency is not well studied in Indian HSCT recipients. A cohort of 55 HSCT recipients were enrolled prospectively for respiratory episodes. Real-time polymerase chain reaction was performed for respiratory viral aetiology. A total of 153 episodes of acute respiratory infections occurred, [107 episodes (mean; 2.8/patient) in autologous HSCT (n=38); 46 episodes (mean; 2.7/patients) in allogeneic HSCT (n=17)]. From these episodes, 70 samples could be tested for respiratory viruses, of which 33 (47.1%) samples tested positive. A higher infection rate (52%; 26/50) was seen in autologous HSCT compared with allogeneic HSCT (35%; 7/20). Rhinoviruses were detected most often (18/33; 54.5%), followed by parainfluenza viruses, (PIV, 6/33; 18.1%). Human metapneumoviruses, (hMPV) and influenza A/H3N2 were detected in 4 samples each (4/33; 12.1%) followed by respiratory syncytial virus (RSV, 2/33; 6.1%). Of the 13 patients with an unfavourable outcome, 4 had respiratory viral infections. Significantly higher fatality was observed in allogeneic than in autologous recipients. Respiratory viruses cause multiple episodes of infection contributing to morbidity and mortality in HSCT recipients.