Treatment and prevention of respiratory syncytial virus infection.

Abstract

This review discusses the current knowledge on treatment and prevention of respiratory syncytial virus (RSV) infections in children. Unfortunately, an effective therapy is not yet available. The efficacy of corticosteroids and bronchodilators has not yet been adequately documented and the use of ribavirin is only indicated in a highly selected group of high risk patients with T-cell immunodeficiency. The results of studies on the efficacy of vitamin A, interferon and antibiotics showed disappointing results. Vaccination research has produced candidate vaccines such as the recombinant vaccine BBG2Na, a subunit vaccine PFP-2 and cold-passaged-temperature sensitive vaccines. However, phase III efficacy trials in infants, young children and the elderly are still lacking. Passive protection against infections by RSV can be conferred by the use of RSV hyperimmune globulin or by the administration of palivizumab, a monoclonal antibody. However, large costs are involved. In addition, major differences have been reported in the prevalence of RSV lower respiratory tract infections in different countries, regions and even within well-known high-risk populations. We suggest the development of local and regional guidelines based on hospitalisation rates in high-risk infants and cost-benefit analysis studies.