Human Rhinovirus Types and Association with Respiratory Symptoms During the First Year of Life

Abstract

The most effective management strategy for viral infections is prevention through vaccines, as reported in a pilot study of herpes zoster vaccination in 10 adult SLE patients older than 50 years of age, 12 but the efficacy and safety of this live-attenuated virus vaccine in a large SLE population is unknown.In conclusion, lupus in children has a higher susceptibility to HZI and is characterized by a shorter disease duration, disease activity and lower frequency of postherpetic neuralgia than in adults with SLE. Both groups have a comparable and good overall outcome. H uman rhinoviruses (HRV) are the most common respiratory viruses identified in humans with respiratory infections, 1 and they play a major role in respiratory morbidity of children. ACKNOWLEDGMENT2,3 HRVinduced wheezing during early life is strongly associated with the later development of asthma. 4 Based on their genetic divergence, HRVs are divided into 3 species: HRV-A, HRV-B and HRV-C, of which HRV-A and HRV-C are thought to cause most severe symptoms.5 For each HRV species, various types are known. Despite the high frequency of HRV infections, detailed information is lacking on prevalence of HRV types and their association with presence and severity of respiratory symptoms, especially in early infancy of otherwise healthy children. Therefore, we analyzed weekly nasal swabs for HRV presence, sequenced positive samples for HRV typing and compared the results with respiratory symptoms. METHODSIn a subsample of 20 healthy infants (9 female, 11 male) nested in the prospective Basel-Bern-Infant-Lung-Development cohort study, 6 we analyzed the presence of HRV RNA by onestep real-time polymerase chain reaction in nasal swabs collected weekly during the first year of life. HRV-positive samples were further sequenced to determine HRV types (for method see Tapparel et al 7 ). Signs of respiratory symptoms (cough, wheeze and breathing difficulties) were assessed based on a standardized symptom score by weekly telephone interviews with the parents. 6 The study was approved by the Ethics Committee Bern, Switzerland and written informed consent was obtained from the parents. RESULTS Prevalence of HRV Species and TypesHRV was detected in 266 of 831 nasal swabs (32%). HRV-A and HRV-C were almost equally frequent (38% and 39%, respectively), followed by HRV-B (12%). Ten percent of the samples were untypable (because of poor sample quality or undetectable viral load). In total, 74 different HRV types were identified (30 HRV-A, 8 HRV-B and 36 HRV-C). Twelve HRV types of all 3 species were particularly frequent and found in 5 or more samples: A78 (detected in 17 samples), A16 (in nine samples), B6 (in 8 samples), A56, A89 (both in 7 samples), A101, C1, C9 (all in 6 samples), A12, C22, C26 and C39 (all in 5 samples). Those HRV types were identified in samples of 1 (A12), 3 (B6, A89, C1), 4 (A16, A56, Association of HRV Prevalence and Respiratory SymptomsIn total, half of HRV-positive episodes were accompanied by respiratory symptoms, with slight differences among ...

Rhinovirus in Febrile Infants and Risk of Bacterial Infection

“…These data are similar to surveillance studies in which non-HRV respiratory viruses are generally detected in <5% of weekly tests, whereas HRV is found in >30%. 9,11 Most multiplex PCR-based testing that includes HRV, such as the Luminex and FilmArray panels used in our study, are qualitative and do not distinguish between HRV and EV. 23,24 In 2 studies in which sequencing has been done in either adults or children to confirm HRV or EV, the majority of HRV and/or EV detections (80%-90%) are found to be HRV.…”

“…Although there are limited data on the frequency of respiratory virus detection in infants 1 to 90 days old, a number of studies have shown that respiratory virus detection is common in young children, particularly infants <1 year old. 9,11,12,22 Longitudinal surveillance studies report the detection of at least 1 respiratory virus in >50% of weekly tests. 11 In our study of febrile infants, ∼55% of infants were positive for 1 or more respiratory viruses, and 38% had HRV detected.…”

“…Studies have shown that ∼50% of HRV detections are associated with symptoms. 9,11 Although young children are more often symptomatic than older children, young infants (<6 months old) are frequently asymptomatic. 11,25 The high rate of detection and frequency of asymptomatic infection make the interpretation of HRV detection difficult in the context of the febrile infant.…”

“…8 -11 Prolonged shedding of HRV has been documented. 9,11,12 Although data from studies of influenza and respiratory syncytial virus (RSV) have been used to suggest that a more limited evaluation and/or early discharge could be considered for febrile infants who are positive for these infections, 1,2,13,14 no data exist to describe the risk of bacterial infection in febrile infants who are HRV-positive.…”

Interactions of Respiratory Viruses and the Nasal Microbiota during the First Year of Life in Healthy Infants

“…One drawback of existing studies investigating the microbiota and viral infections is the lack of including samples during asymptomatic periods of viral colonization, as information about asymptomatic HRV colonization in infancy is scarce in general (13,28,29). This is, however, needed if one aims to differentiate between asymptomatic HRV colonization and HRV infection.…”