Human Rhinovirus Infection In Children Research Articles

Clinical Outcomes of Human Rhinovirus/Enterovirus Infection in Pediatric Hemopoietic Cell Transplant Patients.

Respiratory viral infections are common among pediatric transplant patients, with human rhinovirus (HRV) being the most frequent. In pediatric patients undergoing hemopoietic cell transplant (HCT), infection with HRV has been associated with progression to lower respiratory tract infection (LRTI) and adverse outcomes. We describe the clinical presentation and outcomes of HRV infection in children undergoing HCT. Single-center retrospective study. HCT recipients who were positive for HRV/EV (HRV+) or negative for any respiratory virus (VN) by BioFire® FilmArray® panel between October 2014 and December 2017, were included. Primary outcomes were progression to LRTI, ICU admission, all-cause mortality at 3 and 6 months, and respiratory event-related mortality at 6 months. 227 patients (160 allogeneic HCT) were included. Of all patients, 108/227 (47.6%) were HRV+. From all HRV+, 95/108 (88%) were symptomatic and 68/107 (63.6%) of the diagnosis were made pretransplant. The median age of HRV+ was significantly lower than VN patients (5 vs 10 years). Cough and rhinorrhea were more frequently observed in HRV+ (53.7 and 60% vs 19.8 and 22.8%, respectively). No differences were found between both groups pretransplant and overall in rates progression to LRTI, ICU admission, mechanical ventilation, all-cause within 3 and 6 months, and mortality related with respiratory failure. No significant association was found between the severity of respiratory disease and the type of conditioning, type of transplant, or absolute lymphocyte count. HRV infection is frequently detected in HCT recipients but is not associated with severity of respiratory disease, need for intensive care unit or mortality, including those diagnosed before transplant, suggesting that delaying HCT in this scenario may not be needed. Multicenter larger studies are required to confirm these findings.

Progress in human rhinovirus infection in children

Human rhinovirus(hRV )has been recognized as an important pathogen causing respiratory tract infections in children.HRV belongs to the small RNA virus family.The viral capsid consists of four viral capsid proteins, VP1, VP2, VP3 and VP4.VP1 is the major antigen that producing protective antibodies.There are more than 120 serotypes of hRV.HRV is transmitted mainly through the respiratory tract, and infants are susceptible to hRV.HRV binds intercellular adhesion molecule -1(ICAM-1)of airway epithelial cells, replicating in airway epithelial cells and local lymph tissues, causing inflammatory reaction and releasing inflammatory mediators, which can cause respiratory symptoms.HRV can not only cause respiratory tract infection, but also has close relationship with the onset of asthma in children.Among the various detection methods, RT-PCR has been proved to be rapid and sensitive, and widely used in the detection of hRV.Anti-hRV drugs are still in development. Key words: Human rhinovirus; Children; Respiratory tract infection; Asthma

Epidemiological analysis and follow-up of human rhinovirus infection in children with asthma exacerbation.

To determine the prevalence of human rhinovirus (HRV) infection in children with acute asthma exacerbations, investigation of HRV viral load and severity of asthma exacerbations is also required. Nasopharyngeal aspirates and swabs were collected and assessed for respiratory viruses. HRV‐positive samples were sequenced to identify types and determine viral load. Outpatients with asthma exacerbations underwent follow‐up evaluations, their swabs were collected and clinical outcomes were recorded at their next clinic visit 4 weeks later. One hundred forty‐three inpatients and 131 outpatients, including 88 patients with asthma exacerbations and 43 controls with stable asthma were recruited. HRV‐A was mainly detected in September and February (45.5% and 33.3%, respectively), while HRV‐C was mainly detected in November and April (70.0% and 55.6%, respectively). HRV‐C was the primary type and was primarily found in inpatients with severe asthma exacerbations. HRV‐A viral load in the group of inpatients with severe exacerbations was higher than in the mild and moderate groups (P < 0.001 and P = 0.022). The HRV‐A viral load of both inpatients and outpatients was higher than that of HRV‐C (P < 0.001 and P = 0.036). The main genotypes were HRV‐C53 and HRV‐A20 among inpatients, and this genotype caused more severe clinical manifestations. HRV persisted for no more than 4 weeks, and their symptoms or signs of disease were well‐controlled well. HRV‐C was most frequently detected in asthma exacerbations. HRV‐A with high viral load led to severe asthma exacerbations.

Seasonal variations of respiratory viruses and etiology of human rhinovirus infection in children

BackgroundUsing the polymerase chain reaction (PCR) method it is possible to detect uncultivable viruses and discover multiple viral infections. However, the clinical importance of these findings in relation to symptoms is not known. ObjectivesThe seasonal fluctuations of respiratory viruses and the clinical outcomes of single infections and dual infections were investigated. Study designNasal aspirate samples were obtained from outpatients and inpatients of a children’s hospital and these samples were subjected to real-time PCR to detect 16 respiratory viruses. Seasonal variations of the 16 viruses and the clinical outcomes such as wheezing, the need for oxygenation and prolonged hospitalization of patients with single viral infections and multiple infections were determined for the 5 most often detected viruses. ResultsAmong 512 specimens analyzed, one or more viruses were detected in 424 (83%) specimens. Two or more viruses were detected in 160 samples (31% of all samples). The epidemic peaks of the viruses did not coincide with each other. Rhinoviruses were the most frequently detected viruses and their coinfection rates were also higher. However, the disease severity in the lower respiratory tract did not differ in most respiratory viral infections regardless of whether there was single infection or dual infection with a rhinovirus and other respiratory virus. ConclusionsSeasonal distribution was seen for each virus. There were no significant differences in clinical symptoms in the children studied. Because the infection of rhinoviruses is the common occurrence in children, it is hypothesized that the factors related to disease severity are mainly the underlying conditions of the children.

Human rhinovirus infection in children with acute lower respiratory tract infections

Objective To investigate the clinical and molecular epidemiologic features of human rhinovirus (HRV) in children with acute lower respiratory tract infection (ALRTI) in Shanghai by detecting HRV from bronchoalveolar lavage fluid (BALF). Methods One hundred and thirty-five BALF samples were collected from children with ALRTI at Children's Hospital of Fudan University from January to June in 2014. The specimens were tested by one-step real-time reversible transcription (RT)-polymerase chain reaction (PCR) for HRV. Gene fragments of VP4/VP2 capsid protein of the HRV genome were amplified and sequenced. The phylogenetic trees of HRV strains were drawn. Chi-square test was used for statistical analysis. Result Among these 135 samples, 6(4.4%) were HRV positive, including 4 positive for HRV-A and 2 positive for unknown genotype. The age of children with HRV positive was 8 months to 8 years, including 5 cases ≤3 years old. The nucleotide homology within 4 HRV-A samples varied 76.5%-100.0%. These 4 HRV-A sequences were respectively compared with reference strains of HRV-A, HRV-B and HRV-C in GenBank. The nucleotide homology varied 73.1%-91.7%, 57.8%-66.0% and 59.0%-65.0%, respectively. Among 135 children with ALRTI, 124 were diagnosed with ordinary pneumonia including 4 (3.2%, 4/124) HRV positive and 11 were diagnosed with severe pneumonia (with respiratory failure and/or heart failure) including 2 HRV positive. All children with HRV presented with fever and cough. Most of them (5/6) were co-infected with other pathogens. In 5 children with HRV positive, the peripheral blood leukocyte counts were less than 10×109/L, neutrophil percentages were less than 0.50, C-reactive protein was less than 8 mg/L and procalcitonin was less than 0.05 μg/L. All the children were clinically cured. Conclusions The detection of HRV in BALF samples indicates that HRV is one of the pathogens in children with ALRTI in Shanghai and HRV-A is more common. Gene fragments of VP4/VP2 capsid protein of HRV pathogenic strains display a high degree of genetic variability. Key words: Rhinovirus; Child; Acute lower respirtory infections; Bronchoalveolar lavage fluid

Human Rhinovirus Infection in Children with Cystic Fibrosis

Nasopharyngeal swabs obtained from 78 pediatric patients with cystic fibrosis (CF), including 47 with acute pulmonary exacerbation and 31 in a stable clinical condition, were evaluated for 17 respiratory viruses. Human rhinovirus (HRV) was the most frequently detected virus in patients with pulmonary exacerbation and in those who were clinically stable (21.3% vs. 12.9%; P = 0.52). HRV-A was the main RV detected in patients with pulmonary exacerbations. However, no prevalence of particular HRV-A subtypes was found. This study highlights that RV is frequently found in the respiratory secretions of patients with CF and the impact of HRV-A appears higher than that of the other HRV types in patients with pulmonary exacerbations.

Virus shedding after human rhinovirus infection in children, adults and patients with hypogammaglobulinaemia

The shedding of human rhinovirus (HRV) after an acute, naturally acquired infection has not been described in detail. We determined the duration of HRV shedding in immunocompetent children and adults, and in patients with primary hypogammaglobulinaemia. Subjects with symptoms of respiratory tract infection, and their household contacts, were screened for HRV by reverse transcription PCR. They were followed by serial, self-collected nasal swab specimens until negative for HRV or infected by another HRV type. We followed 62 HRV infections in 54 subjects. The mean (95% CI) duration of HRV shedding was 11.4 (8.2–14.7) days in children, 10.1 (7.4–12.9) days in adults, and 40.9 (26.4–55.4) days in patients with hypogammaglobulinaemia (p <0.001). The duration of respiratory tract symptoms correlated with the duration of virus shedding (p 0.002). A new infection by another HRV type soon after the first episode was common. We conclude that the shedding times of HRV are relatively short in otherwise healthy individuals. In contrast, prolonged shedding over 28 days is frequent in patients with hypogammaglobulinaemia despite immunoglobulin replacement therapy.

New Aspects on Human Rhinovirus Infections

New Aspects on Human Rhinovirus Infections

Human rhinovirus infection in children with lower respiratory tract infection and asthmatic children in southern Taiwan

Human rhinovirus infection in children with lower respiratory tract infection and asthmatic children in southern Taiwan

Rhinovirus infection and acute exacerbation of asthma in children

Human rhinovirus (HRV) infection is an important predisposing factor of acute asthma attacks and exacerbations, but the pathogenic mechanism is extremely complex. Inflammatory responses can be caused by the direct effect of rhinovirus and the release of inflammatory mediators and inflammatory cell infiltration. HRV infection stimulates the body's abnormal immune response, especially Thl / Th2 immune imbalance and dysfunction of regulatory T cells has attracted extensive attention. In-depth study in the pathogenic mechanism of acute asthma exacerbation induced by HRV infection in children is essential to elucidate the pathogenesis of asthma and to explore immunotherapy of asthma. Key words: Rhinovirus; Asthma; Acute exacerbation