Epidemiologic and clinical characteristics of human bocavirus infection in children hospitalized for acute respiratory tract infection in Qingdao, China

Abstract

Persistent infection and prolonged shedding of human bocavirus 1 (HBoV1) in children have been reported, and the role of HBoV1 as a sole causative pathogen in acute respiratory infection (ARI) is yet to be established. While the reported prevalence of HBoV infection varies due to different detection methods and sampling criteria, determining the viral and bacterial etiology of HBoV infection using multiplex real-time PCR is yet to be reported. Herein, we aimed to further explore the pathogenicity of HBoV in patients with ARI by screening the viral and bacterial infections in children with ARI in Qingdao and comparing the epidemiological, clinical characteristics, and etiological results. Human bocavirus was identified in 28.1% of the samples, and further sequencing analysis of the detected HBoV confirmed 96.4% as HBoV1. The rate of HBoV as a single viral infection was 75%, and the rate of coinfection with bacteria was 66.1%, suggesting the need for continued monitoring of HBoV in children with ARIs. Clinical characterization suggested that HBoV infection may affect the function of organs, such as the liver, kidney, and heart, and the blood acid–base balance. Additionally, it is essential to promote awareness about the importance of disinfection and sterilization of the hospital environment and standardizing operations. The interactions between HBoV and other pathogens remain to be investigated in further detail in the future.

Human Bocavirus in Childhood: A True Respiratory Pathogen or a “Passenger” Virus? A Comprehensive Review

“…Several clinical studies have identified HBoV1 as one of the most detected respiratory viruses in young children with RTIs and, as with other respiratory viruses, it is widespread in both low- and high-income countries [ 1 , 2 , 3 ]. Most studies showed a higher prevalence in males [ 1 , 4 , 5 , 6 , 7 , 8 , 9 ], others did not find any sex predominance [ 10 ], and a few showed a slightly higher prevalence among females [ 3 , 11 , 12 ].…”

“…Most literature reported HBoV infection as prevalent in children between 6 months and 2 years with the highest detection rate during the second year [ 4 , 6 , 10 , 12 , 13 , 14 ], while it is rare (<5%) during the first 6 months of life [ 15 , 16 ]. Only in the study by Wang et al were children > 5 years the most affected, followed by children < 2 years and infants [ 1 , 15 , 16 ].…”

“…In China, two studies by De et al and Tang et al on children hospitalized for lower RTIs found a detection rate of 6.88% [ 25 ] and 6.62% [ 4 ], respectively, with a significantly higher number of infected children aged between 1 to 3 years than in other age groups [ 4 ]. In a smaller Chinese cohort of 199 cases with RTIs [ 1 ], HBoV was the most common virus, found in 28.1% of subjects, significantly higher than the 10% rate reported by Ji et al who tested 878 children with community-acquired pneumoniae (CAP) [ 6 ].…”

“…Human bocavirus (HBoV, lately denoted HBoV1) is a parvovirus that was isolated ten years ago, mainly affecting the lower respiratory and gastrointestinal tracts in childhood all over the world. It is a small, icosahedral, linear, non-enveloped, single-stranded DNA virus measuring between 18 and 26 nm [ 1 ]. It was first identified by Allander in 2005 in 17 respiratory samples from children suffering from acute respiratory tract infections (RTIs) of suspected viral origin in Sweden [ 2 ].…”

“…HBoV can be detected alone or, more commonly, with other viruses causing respiratory or gastrointestinal infections, such as rhinoviruses, adenoviruses, noroviruses, and rotaviruses [ 1 , 4 ]; viral co-infection with the respiratory syncytial virus (RSV) is frequently found [ 1 , 21 ]. Furthermore, HBoV can be associated with bacterial co-infections, often with a severe course.…”