scholarly journals Respiratory Syncytial Virus Prophylaxis in Special Populations: Is it Something Worth Considering in Cystic Fibrosis and Immunosuppression?

2011 ◽  
Vol 16 (2) ◽  
pp. 77-86
Author(s):  
William A. Prescott ◽  
David J. Hutchinson
Keyword(s):  
Respiratory Syncytial Virus ◽  
Cost Benefit ◽  
The United States ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
The Cost ◽  
Infant Hospitalization ◽  
Infants And Young Children

ABSTRACT Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of infant hospitalization in the United States. Prophylaxis with palivizumab is effective in reducing RSV hospitalizations in premature infants and in infants or children with chronic lung disease or congenital heart disease. Patients with CF or those who are immunocompromised may be at increased risk for RSV infection–related complications; hence, prophylaxis may prove beneficial to these populations. The extent of palivizumab use in the CF and immunocompromised populations is variable. Palivizumab appears to be safe and may be effective in infants and young children with CF and immunocompromise. However, well-designed, randomized, controlled trials published in peer-reviewed journals are lacking, and its routine use can therefore not be recommended at this time. If used in patients with CF or those who are immunocompromised, RSV prophylaxis should be restricted to peak outbreak months in order to optimize the cost benefit of palivizumab.

scholarly journals 717. Cumulative Incidence of Asthma/Wheezing Among Neonates/Infants/Toddlers Clinically Diagnosed with Respiratory Syncytial Virus Infection in the United States: A Retrospective Database Analysis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S257-S258
Author(s):  
Veronique Wyffels ◽  
Maartje Smulders ◽  
Sandra Gavart ◽  
Debasish Mazumder ◽  
Rohit Tyagi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Respiratory Syncytial Virus ◽  
Cumulative Incidence ◽  
The United States ◽  
Term Infants ◽  
Increased Risk ◽  
Study Results ◽  
Syncytial Virus ◽  
Time Required

Abstract Background The role of respiratory syncytial virus (RSV) in the development of asthma/wheezing (AW) has been evaluated in several studies, mostly among pre-term infants or among infants after developing severe RSV-related disease. We describe the cumulative incidence (CI) of AW among hospitalized/ambulatory neonates/infants/toddlers after RSV/bronchiolitis infection diagnosis, in a large clinical database. Methods Using deidentified Optum Integrated commercial claims and electronic medical records, we identified patients (0–<3 years old) with a first clinical diagnosis of RSV/bronchiolitis infection from 01 January 2008–31 March 2016. Patients with a diagnosis of asthma/wheezing ≤30 days after first RSV/bronchiolitis diagnosis were excluded. Three cohorts were created with 1/3/5 years of follow-up time required, respectively. Patients were grouped by specific high-risk factors (HRF+/−), including pre-term births and predefined pre-existing disease. Descriptive statistics are reported, with comparisons made by logistic regression analyses. Results 9,811/4,524/1,788 patients with RSV/bronchiolitis infection and HRF− were included in the 1/3/5-years follow-up cohorts. 14.9%/28.2%/36.3% had AW events by the end of follow-up in the three cohorts. 6.5%/6.9%/5.8% were hospitalized for RSV/bronchiolitis. 3,030/1,378/552 patients with RSV/bronchiolitis infection and HRF+ were included in the 1/3/5-years follow-up cohorts. 18.1%/32.9%/37.9% had AW events by the end of follow-up in the three cohorts. 11.4%/11.1%/11.6% were hospitalized for RSV/bronchiolitis. The CI rates of AW in the 1/3/5-year HRF+/− cohorts, stratified by hospitalized for RSV/bronchiolitis Y/N, are shown in Figure 1. Logistic regression confirmed that hospitalization for RSV/bronchiolitis was associated with an increased (P < 0.05) likelihood of AW, for HRF+ and HRF− patients at each follow-up year. Conclusion Thirty-eight percent of RSV/bronchiolitis infants/neonates/toddlers HRF+, and 36% among infants/neonates/toddlers HRF−, developed AW in the 5 years after first RSV/bronchiolitis diagnosis. RSV/bronchiolitis hospitalization was associated with a significantly increased risk of AW development in 1/3/5 years of follow-up; confirming previous observational study results. Disclosures V. Wyffels, Janssen: Employee, Salary. M. Smulders, SmaertAnalyst: Consultant, Consulting fee. S. Gavart, Janssen: Employee, Salary. D. Mazumder, SmartAnalyst: Consultant, Consulting fee. R. Tyagi, SmartAnalyst: Consultant, Consulting fee. N. Gupta, SmartAnalyst: Consultant, Consulting fee. R. Fleischhackl, Janssen: Employee, Salary.

scholarly journals Infant baboons infected with respiratory syncytial virus develop clinical and pathological changes that parallel those of human infants

2013 ◽  
Vol 304 (8) ◽  
pp. L530-L539 ◽  
Author(s):  
James F. Papin ◽  
Roman F. Wolf ◽  
Stanley D. Kosanke ◽  
Justin D. Jenkins ◽  
Sara N. Moore ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Alveolar Epithelium ◽  
Inflammatory Cells ◽  
The United States ◽  
Pathological Changes ◽  
Papio Anubis ◽  
Human Infants ◽  
Infected Infant ◽  
Rsv Infection ◽  
Syncytial Virus

Respiratory syncytial virus (RSV) infection of the lower respiratory tract is the leading cause of respiratory failure among infants in the United States of America and annually results in >300,000 deaths worldwide. Despite the importance of RSV, there is no licensed vaccine, and no specific form of therapy. This is largely due to the absence of an appropriate animal model for the evaluation of vaccines and therapeutic agents. We inoculated anesthetized infant (4 wk) baboons ( Papio anubis) with a human strain of RSV intranasally or intratracheally. Baboons were monitored daily for clinical changes. Anesthetized baboons were intubated at various intervals, and bronchoalveolar lavage (BAL) was performed for viral culture and determination of leukocyte counts. Sham-infected baboons served as controls. Necropsies were performed on infected baboons on days 1, 3, 5, 8, or 13 after inoculation, with pathological analysis and immunohistochemical staining of lung tissues to detect RSV antigen. Infected baboons developed tachypnea and reduced oxygenation peaking from 4 to 8 days after infection and persisting for ≥14 days. Virus was recoverable in BAL fluid up to 8 days following infection. Necropsy revealed intense interstitial pneumonia, sloughing of the bronchiolar epithelium, and obstruction of the bronchiolar lumen with inflammatory cells and sloughed epithelial cells. RSV antigen was identified in bronchiolar and alveolar epithelium. We conclude that RSV-infected infant baboons develop clinical and pathological changes that parallel those observed in human infants with RSV infection. The infant baboon represents a much-needed model for studying the pathogenesis of RSV infection and evaluating antivirals and vaccines.

scholarly journals Epidemiologic, Experimental, and Clinical Links between Respiratory Syncytial Virus Infection and Asthma

2008 ◽  
Vol 21 (3) ◽  
pp. 495-504 ◽  
Author(s):  
Shyam S. Mohapatra ◽  
Sandhya Boyapalle
Keyword(s):  
Respiratory Syncytial Virus ◽  
Childhood Asthma ◽  
Molecular Mechanisms ◽  
Viral Infections ◽  
Severe Disease ◽  
Infection Process ◽  
Increased Risk ◽  
Rsv Infection ◽  
Recurrent Wheeze ◽  
Syncytial Virus

SUMMARY Virtually all children experience respiratory syncytial virus (RSV) infection at least once during the first 2 years of life, but only a few develop bronchiolitis and more severe disease requiring hospitalization, usually in the first 6 months of life. Children who recover from RSV-induced bronchiolitis are at increased risk for the development of recurrent wheeze and asthma in later childhood. Recent studies suggest that there is an association between RSV-induced bronchiolitis and asthma within the first decade of life but that this association is not significant after age 13. Despite the considerable progress made in our understanding of several aspects of respiratory viral infections, further work needs to be done to clarify the molecular mechanisms of early interactions between virus and host cell and the role of host gene products in the infection process. This review provides a critical appraisal of the literature in epidemiology and experimental research which links RSV infection to asthma. Studies to date demonstrate that there is a significant association between RSV infection and childhood asthma and that preventing severe primary RSV infections can decrease the risk of childhood asthma.

scholarly journals Antibody Responses to Respiratory Syncytial Virus: A Cross-Sectional Serosurveillance Study in the Dutch Population Focusing on Infants Younger Than 2 Years

2020 ◽  
Author(s):  
Guy Berbers ◽  
Liesbeth Mollema ◽  
Fiona van der Klis ◽  
Gerco den Hartog ◽  
Rutger Schepp
Keyword(s):  
Respiratory Syncytial Virus ◽  
Chronic Obstructive ◽  
Igg Antibody ◽  
Cross Sectional ◽  
Mild Disease ◽  
Copd Patients ◽  
Increased Risk ◽  
Iga Antibodies ◽  
Rsv Infection ◽  
Syncytial Virus

Abstract Background Respiratory syncytial virus (RSV) generally causes mild disease but can cause severe infections in (premature) infants and elderly adults. Here, we studied RSV-specific antibody concentrations throughout life with emphasis on infants and chronic obstructive pulmonary disease (COPD) patients. Methods Sera (N = 2655) from 2 nationwide cross-sectional studies in the Netherlands including individuals aged 0–90 years were analyzed for IgG and IgA antibodies to RSV prefusion F, postfusion F, N, Ga, and Gb proteins and for antibody avidity in 42 COPD patients. Results Maternal IgG concentrations declined to age 10–12 months. After the first year of life, approximately 40% of children lacked infection-induced IgA antibodies and may therefore be uninfected. All Dutch children showed serological evidence of RSV infection by age 3 years. Antibody concentrations reached a plateau by age 5–9 years and remains constant throughout life. COPD patients had similar levels and avidity of RSV-specific IgG antibodies compared with age-matched healthy controls. Conclusions RSV-IgG antibody patterns throughout life can be used to estimate the degree of immunity acquisition to RSV and to identify groups at increased risk of infection. Seroprevalence of IgA could be a proxy to determine RSV infection in children younger than 1 year.

Immune profiles provide insights into respiratory syncytial virus disease severity in young children

2020 ◽  
Vol 12 (540) ◽  
pp. eaaw0268 ◽  
Author(s):  
Santtu Heinonen ◽  
Victoria M. Velazquez ◽  
Fang Ye ◽  
Sara Mertz ◽  
Santiago Acero-Bedoya ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Disease Severity ◽  
Virus Disease ◽  
Severe Disease ◽  
Mild Disease ◽  
Hla Dr ◽  
Increased Risk ◽  
Determining Factors ◽  
Rsv Infection ◽  
Syncytial Virus

Respiratory syncytial virus (RSV) is associated with major morbidity in infants, although most cases result in mild disease. The pathogenesis of the disease is incompletely understood, especially the determining factors of disease severity. A better characterization of these factors may help with development of RSV vaccines and antivirals. Hence, identification of a “safe and protective” immunoprofile induced by natural RSV infection could be used as a as a surrogate of ideal vaccine-elicited responses in future clinical trials. In this study, we integrated blood transcriptional and cell immune profiling, RSV loads, and clinical data to identify factors associated with a mild disease phenotype in a cohort of 190 children <2 years of age. Children with mild disease (outpatients) showed higher RSV loads, greater induction of interferon (IFN) and plasma cell genes, and decreased expression of inflammation and neutrophil genes versus children with severe disease (inpatients). Additionally, only infants with severe disease had increased numbers of HLA-DRlow monocytes, not present in outpatients. Multivariable analyses confirmed that IFN overexpression was associated with decreased odds of hospitalization, whereas increased numbers of HLA-DRlow monocytes were associated with increased risk of hospitalization. These findings suggest that robust innate immune responses are associated with mild RSV infection in infants.

Nosocomial Respiratory Syncytial Virus Infections: The Cost-Effectiveness and Cost-Benefit of Infection Control

PEDIATRICS ◽  
2000 ◽  
Vol 106 (3) ◽  
pp. 520-526 ◽  
Author(s):  
K. K. Macartney ◽  
M. H. Gorelick ◽  
M. L. Manning ◽  
R. L. Hodinka ◽  
L. M. Bell
Keyword(s):  
Respiratory Syncytial Virus ◽  
Cost Effectiveness ◽  
Infection Control ◽  
Cost Benefit ◽  
Virus Infections ◽  
Respiratory Syncytial Virus Infections ◽  
Syncytial Virus ◽  
The Cost
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