Detection of human rhinoviruses in the lower respiratory tract of lung transplant recipients

Abstract

The occurrence of human rhinoviruses (HRV) and its relationship to clinical and histopathological findings were investigated in 127 bronchoalveolar lavage specimens from 36 lung transplant recipients by real-time RT-PCR. In addition, 286 samples from 235 other immunocompromised and immunocompetent patients were also studied. HRV was detected in 41.7% of lung transplant recipients vs 14.5% of other patients (p < 0.0001), and no differences in viral load were observed. Acute respiratory insufficiency was found in 15 cases, three of which were HRV positive (viral load, 6.3 x 10(6) RNA copies/ml in one patient with chronic graft dysfunction). A diagnosis of pneumonia was made in 10 out of 127 cases, two of which were HRV positive (viral load, 10(3)-10(4) in cases of co-infection). Acute rejection was diagnosed in 12 cases, three of which were HRV positive (viral load, 10(3) in two cases of co-infection and 10(5) in a single infection). HRV infection may involve the lower respiratory tract, particularly in the presence of an impaired pulmonary background, such as a transplanted lung. Clinical evaluation should take into account the viral load, with a load of >10(5) possibly being associated with clinical symptoms, although lower loads can be detected in both symptomatic and asymptomatic patients.

Azithromycin reduces airway inflammation induced by human rhinovirus in lung allograft recipients

“…Interestingly, viral replication was similar between LAEC and SAEC, suggesting that no regional differences exists in their susceptibility to RV infection. The resulting viral load (LAEC: 4.67 ± 1.23 × 10 3 #copy/ng RNA, SAEC: 3.58 ± 0.48 × 10 3 #copy/ng RNA) was found to be comparable to other clinical observations including the one conducted by Costa and colleagues (4.10 ± 0.16 × 10 5 RNA copies/mL) determined from BAL fluid specimens of lung allograft recipients and another by Ambrosioni et al (1.25 × 10 4 –1.99 × 10 8 RNA copies/mL) obtained from the upper respiratory tract of lung transplant recipients …”

Clinical relevance of rhinovirus infections among adult hospitalized patients

“…3,[25][26][27] Its frequency may surpass other viral agents as a cause of respiratory infections. 12 Admissions by HRV infection are associated with asthmatic crisis, chronic medical conditions, malignancies, or immunosuppression, 11,[28][29][30][31][32] and occurs during the influenza season as beyond this timeframe. 16 In addition, HRV has been associated to outbreaks with an increased case-fatality ratio.…”

Prolonged shedding of rhinovirus and re-infection in adults with respiratory tract illness

“…It is also a commonly detected copathogen identified in 24% and 30% of mixed viral and bacterial infections, respectively [3,4]. Rhinovirus infection might contribute to serious complications such as obliterative bronchiolitis and acute graft rejection in lung and stem-cell transplant recipients [5][6][7].…”