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

Abstract

Rhinovirus infections occur frequently throughout life and have been reported in about onethird of asymptomatic cases. The clinical significance of sequential rhinovirus infections remains unclear.To determine the incidence and clinical relevance of sequential rhinovirus detections, nasopharyngeal samples from 2485 adults with acute cough/lower respiratory illness were analysed. Patients were enrolled prospectively by general practitioners from 12 European Union countries during three consecutive years (2007)(2008)(2009)(2010). Nasopharyngeal samples were collected at the initial general practitioner consultation and 28 days thereafter and symptom scores were recorded by patients over that period.Rhinovirus RNA was detected in 444 (18%) out of 2485 visit one samples and in 110 (4.4%) out of 2485 visit two respiratory samples. 21 (5%) of the 444 patients had both samples positive for rhinovirus. Genotyping of both virus detections was successful for 17 (81%) out of 21 of these patients. Prolonged rhinovirus shedding occurred in six (35%) out of 21 and re-infection with a different rhinovirus in 11 (65%) out of 21. Rhinovirus re-infections were significantly associated with chronic obstructive pulmonary disease (p50.04) and asthma (p50.02) and appeared to be more severe than prolonged infections.Our findings indicate that in immunocompetent adults rhinovirus re-infections are more common than prolonged infections, and chronic airway comorbidities might predispose to more frequent rhinovirus re-infections. @ERSpublications Chronic airway comorbidities might predispose to more frequent rhinovirus re-infections in immunocompetent adults

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“…In our study it should be underlined that all eight HAP cases with long-term shedding of community-acquired viruses involved immunocompromised patients with coinfection with other pathogens. Shedding of rhinoviruses for more than 4 weeks is not uncommon even in immunocompetent individuals [27] and especially in patients with immunodeficiency in whom chronic rhinovirus carriage for as long as 4-12 months has been documented [28]. The significance of rhinovirus detection in respiratory specimens from pneumonia patients is a subject of some debate.…”

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“…For HRV, the rates of prolonged shedding (same genotype in 35%) versus re-infection (other genotype) in the GRACE study have been further investigated [24].…”