The Burden of Human Bocavirus 1 in Hospitalized Children With Respiratory Tract Infections

Abstract

Background Human bocavirus 1 (HBoV1) is frequently codetected with other viruses, and detected in asymptomatic children. Thus, the burden of HBoV1 respiratory tract infections (RTI) has been unknown. Using HBoV1-mRNA to indicate true HBoV1 RTI, we assessed the burden of HBoV1 in hospitalized children and the impact of viral codetections, compared with RSV. Methods Over 11 years, we enrolled 4,879 children <16 years old admitted with RTI. Nasopharyngeal aspirates were analyzed with polymerase chain reaction for HBoV1-DNA, HBoV1-mRNA and 19 other pathogens. Results HBoV1-mRNA was detected in 2.7% (130/4850) samples, modestly peaking in autumn and winter. Forty-three percent with HBoV1 mRNA were 12-17 months old, and only 5% were <6 months old. A total of 73.8% had viral codetections. It was more likely to detect HBoV1-mRNA if HBoV1-DNA was detected alone (OR: 3.9, 95% CI: 1.7-8.9) or with 1 viral codetection (OR: 1.9, 95% CI: 1.1-3.3), compared to ≥2 codetections. Codetection of severe viruses like RSV had lower odds for HBoV1-mRNA (OR: 0.34, 95% CI: 0.19-0.61). The yearly lower RTI (LRTI) hospitalization rate per 1,000 children <5 years was 0.7 for HBoV1-mRNA and 8.7 for RSV. Conclusions True HBoV1 RTI is most likely when HBoV1-DNA is detected alone, or with one codetected virus. Hospitalization due to HBoV1 LRTI is 10-12 times less common than RSV.

Human bocavirus respiratory infection: Tracing the path from viral replication and virus‐cell interactions to diagnostic methods

“…43,44,52,54,68,117,118 Detection of HBoV1 RNA in paediatric patients, rather than high viral load, has been associated with wheezing and pneumonia, thus it could be useful to identify active infection. 117,[119][120][121][122] An alternative for diagnosis in clinical practice could also be direct testing by antigen detection (immunofluorescence), 88 along with the respiratory panel.…”