Correlation of rhinovirus load in the respiratory tract and clinical symptoms in hospitalized immunocompetent and immunocompromised patients

Abstract

While human rhinoviruses (HRVs) are well accepted as a major cause of common cold syndromes (rhinitis), their role in the etiology of lower respiratory tract infections is still controversial, and their detection in asymptomatic patients is relatively common. The HRV pathogenic role in four groups of hospitalized patients (pediatric immunocompetent and immunocompromised patients, and adult immunocompetent and immunocompromised patients) was investigated by quantifying HRV load in nasopharyngeal aspirates or bronchoalveolar lavage samples by real-time reverse transcription PCR (RT-PCR). Real-time RT-PCR was performed in duplicate on all respiratory samples resulting positive by qualitative RT-PCR. In addition, molecular typing allowed detection of all known HRV species (A, B, and C). In immunocompetent pediatric patients HRVs were mostly associated with lower respiratory tract infections (in the absence of other viral agents) and wheezing, when viral load was > or =10(6) RNA copies/ml. In young immunocompromised patients (stem cell transplantation recipients), an inverse correlation between HRV persistence over time and time at which the infection occurred after transplantation was observed, whereas in adult immunocompromised patients (lung transplant recipients) HRVs could be detected at a medium-low level (<10(5) RNA copies/ml) in bronchoalveolar lavage samples taken routinely from asymptomatic patients. In conclusion, when detected at high viral load, HRVs may cause severe upper and lower respiratory tract infections, whereas when detected at a medium-low viral load, an event more frequent in immunocompromised subjects, they may represent only bystander viruses.

Human rhinovirus in the lower respiratory tract infections of young children and the possible involvement of a secondary respiratory viral agent

“…The high frequency of HRV co-infection with RSV has been observed previously (Papadopoulos et al 2002, Paranhos-Baccalà et al 2008, Gerna et al 2009). In our region, the high prevalence of HRV and RSV co-infection may be related to seasonal trends (Costa et al 2006, Oliveira et al 2008); HRV and RSV infections peak concurrently.…”

“…Due to advances in nucleic acid amplification, we can now detect HRV and determine when HRV is the causative agent of lower respiratory tract illness (LRTI) (Choi et al 2006, Miller et al 2007, Gerna et al 2009, Louie et al 2009). HRV is frequently detected in children diagnosed with bronchiolitis and pneumonia (Manoha et al 2007, Miller et al 2007, Louie et al 2009).…”

“…Scientists have questioned whether or not HRV co-infections lead to more severe clinical syndromes, cause longer hospitalisations and affect younger children more frequently (Drews et al 1997, Papadopoulos et al 2002, Calvo et al 2007, 2008, Gerna et al 2009, Midulla et al 2010.…”

Respiratory virus infections among hospitalized patients with suspected influenza A H1N1 2009 virus during the first pandemic wave in Brazil

“…12 Additionally, it is likely that the national protocol guidance 13 calling for hospitalization of all symptomatic children less than 2 years old with an acute respiratory infection influenced these results.…”

Antibodies induced with recombinant VP1 from human rhinovirus exhibit cross-neutralisation

“…Furthermore, the pathogenic role of HRVs in lower respiratory tract infections of infants, elderly and immunocompromised patients has been reported [6][7][8].…”