Human bocavirus infection as a cause of severe acute respiratory tract infection in children

Abstract

In 2005 human bocavirus (HBoV) was discovered in respiratory tract samples of children. The role of HBoV as the single causative agent for respiratory tract infections remains unclear. Detection of HBoV in children with respiratory disease is frequently in combination with other viruses or bacteria. We set up an algorithm to study whether HBoV alone can cause severe acute respiratory tract infection (SARI) in children. The algorithm was developed to exclude cases with no other likely cause than HBoV for the need for admission to the paediatric intensive care unit (PICU) with SARI. We searched for other viruses by next-generation sequencing (NGS) in these cases and studied their HBoV viral loads. To benchmark our algorithm, the same was applied to respiratory syncytial virus (RSV)-positive patients. From our total group of 990 patients who tested positive for a respiratory virus by means of RT-PCR, HBoV and RSV were detected in 178 and 366 children admitted to our hospital. Forty-nine HBoV-positive patients and 72 RSV-positive patients were admitted to the PICU. We found seven single HBoV-infected cases with SARI admitted to PICU (7/49, 14%). They had no other detectable virus by NGS. They had much higher HBoV loads than other patients positive for HBoV. We identified 14 RSV-infected SARI patients with a single RSV infection (14/72, 19%). We conclude that our study provides strong support that HBoV can cause SARI in children in the absence of viral and bacterial co-infections.

Human bocavirus infection in Belgian children with respiratory tract disease

“…Thus, in our study, only one child out of 77 HBoV-infected children needed hospitalization at the PICU because of severe acute respiratory distress due to HBoV infection. This is lower than the 3.93% observed in a study by Moesker et al [17].…”

“…Furthermore, HBoV has been suggested as a cause of pediatric gastrointestinal (GI) infection [10,11] and might even have a causal role in encephalitis [12][13][14][15]. However, it has also been found in children with mild infections [16] and in asymptomatic ones, and therefore, the pathogenic role of HBoV is still under discussion [8,17]. Classically, Koch's postulates have been used to establish a causal relationship between viruses and disease [18].…”

Comparison of rates of hospitalization between single and dual virus detection in a Mexican cohort of children and adults with influenza-like illness

“…Because HBoV infection is very common and frequently found in asymptomatic participants, the pathogenic role of this virus has been questioned [31,32]. Children with higher viral loads tend to have more severe infections [33], longer hospitalization duration [34,35], and are found to have co-infection by other viruses [36,37] less frequently than those with lower viral loads. However, in children in daycare, viral load had no apparent association with severity of illness [31], which also might reflect challenges in reproducibly measuring viral load in secretions.…”

Comparison of phenotypic and genotypic diagnosis of acute human bocavirus 1 infection in children

“…Human bocavirus 1 (HBoV1) is a common cause of respiratory tract infections (RTI) in young children and causes serious lower RTI in children younger than six years of age [1][2][3][4][5]. The diagnosis of HBoV1 infections has traditionally been based on qualitative PCRs detecting viral DNA.…”