Clinical and radiological features of respiratory syncytial virus in solid organ transplant recipients: a single‐center experience

Abstract

SOT recipients accounted for half of all adult cases of RSV at our institution. Type and length of treatment varied widely, and we cannot conclude that outcomes differed between treatments with oral or inhaled ribavirin. Current therapeutic management of RSV in SOT is empiric, and can be rather expensive and difficult, without clear evidence of effectiveness.

Oral versus inhaled ribavirin therapy for respiratory syncytial virus infection after lung transplantation

“…12 Not only is there a lack of randomized studies to substantiate the use of aerosolized ribavirin for RSV infection in lung transplant patients, but the previously mentioned factors (eg, patient discomfort, inconvenience, financial burden, limitations on medical personnel for patient care) remain substantial obstacles against use of this type of therapy. 8,15 Alternatives for ribavirin administration include oral or intravenous routes, but these delivery methods have not been routinely available for treatment of RSV infection in all countries.…”

“…8,14 Adverse effects reported to be associated with oral ribavirin therapy include hemolytic anemia and gastrointestinal effects. 10,11,15 These multiple modes of ribavirin administration in lung transplant recipients have been reported. 7,8,14,15 We initiated this study to compare the use of oral and nebulized ribavirin therapy in adult lung transplant recipients with RSV infection and evaluate for differences in early BOS progression.…”

Respiratory Syncytial Virus in Hematopoietic Stem Cell Transplantation and Solid-Organ Transplantation

“…Presentation of RSV disease is similar to that described in HSCT patients, with the majority of patients initially demonstrating fever, cough, and dyspnea [60,68,69]. The incidence of mild RSV infection is probably underestimated considerably since diagnostic tests are rarely sent for patients with symptoms of a Bcommon cold.^As seen in HSCT recipients, an association between lower lymphocyte count (mean 580 cells/mm 3 ) and RSV progression to LRD has been noted in SOT patients [68].…”

“…The incidence of mild RSV infection is probably underestimated considerably since diagnostic tests are rarely sent for patients with symptoms of a Bcommon cold.^As seen in HSCT recipients, an association between lower lymphocyte count (mean 580 cells/mm 3 ) and RSV progression to LRD has been noted in SOT patients [68]. Late complications of early-onset RSV lower respiratory tract infection in lung transplant patients has been of greatest concern due to a possible link with development of bronchiolitis obliterans syndrome (BOS), a typically progressive fibrotic process that limits long-term survival in this population.…”

The clinical and phylogenetic investigation for a nosocomial outbreak of respiratory syncytial virus infection in an adult hemato‐oncology unit

“…Although it is recognized as the most common cause of lower respiratory tract infection (LRTI) in children, this virus can also be problematic in immunocompromised patients, especially hemato‐oncology patients . Indeed, recent reports portray this virus as the cause of severe, even life threatening, LRTI in immunocompromised adults, including hemato‐oncology patients . Furthermore, it is understood that RSV can be transmitted easily between hemato‐oncology patients, resulting in outbreaks .…”