A survey strategy for human respiratory syncytial virus detection among haematopoietic stem cell transplant patients: epidemiological and methodological analysis

Abstract

Human respiratory syncytial virus (HRSV) causes severe infections among children and immunocompromised patients. We compared HRSV infections among Haematopoietic Stem Cell Transplant program (HSCT) patients and children using direct immunofluorescence (DFA), point-of-care RSV Bio Easy(r) and a polymerase chain reaction (PCR) assay. Overall, 102 samples from HSCT patients and 128 from children obtained positivity rate of 18.6% and 14.1% respectively. PCR sensitivity was highest mainly on samples collected after five days of symptoms onset. A combination of both DFA and reverse transcriptase-PCR methods for HSCT high-risk patients is the best diagnostic flow for HRSV diagnosis among these patients.

Viral Respiratory Infections in Patients with Cancer

“…In this study, 102 samples were collected from 67 HSCT recipients among whom there were 19 (28.8%) leukemia cases, 22 (33.3%) lymphoma cases and 25 (37.9%) cases with other hematological malignancies who had 4 (22.2%), 7 (38.9%) and 7 (38.9%) positive HRSV samples respectively (Table 1). Two separate episodes of HRSV occurred in one of these patients in 2008 (24). From January 16 to February 4, 2004, 6 RSV infected patients with hematological malignancies were admitted to an adult HSCT unit with the ages of 41, 26, 61, 62, 61 and 67 years who had cutaneous T cell lymphoma, nodular sclerosing Hodgkin disease, multiple myeloma, CML, mantle cell lymphoma and CML respectively, from which the second and the last (33%) developed URTI and other four patients (67%) developed HRSV-associated pneumonia.…”

Respiratory Syncytial Virus: Infection, Detection, and New Options for Prevention and Treatment

“…This is suggestive that historic surveillance data that relied heavily on DFA testing may have been underestimating the true impact of RSVA and RSVB on influenza-like illness rates in pediatric and adult populations, and rates will change as surveillance systems shift between different detection approaches (263). However, depending on workflow and resources within the laboratory, DFA testing as an adjunct to molecular test methods may provide an option for RSV testing in high-risk patients such as hematopoietic stem cell transplant patients (269). Prior to the broader utilization of easier-touse molecular diagnostic assays, DFA testing historically provided a more rapid response than lab-developed and batched molecular assays for RSV (270).…”

Respiratory syncytial virus in hematopoietic cell transplant recipients and patients with hematologic malignancies

“…On the other hand, lower incidences of RSV infections were reported in studies in which molecular assays such as multiplex polymerase chain reaction were used to detect RSV, with the reported range in these cases being 8-30%. 8,9,29 This lower incidence could be explained by the increased rate of diagnosing other respiratory viruses, such as coronavirus, rhinovirus, and parainfluenza, with the use of molecular assays.…”

“…The outcomes of these infections vary on the basis of the patient population, with adverse outcomes having been described in hematopoietic cell transplant (HCT) recipients and patients with a hematologic malignancy (HM). 4–9 One of the most common community respiratory viruses that may lead to the death of HCT recipients and HM patients is respiratory syncytial virus (RSV), 4–10 whose incidence is second only to that of influenza according to prior reports; 4,5,8,11,12 other viruses include parainfluenza virus, metapneumovirus, adenovirus, rhinovirus, and bocavirus.…”