Novel clinical features of recurrent human respiratory syncytial virus infections

Abstract

Children and elderly individuals are often infected easily and repeatedly with human respiratory syncytial virus (HRSV); however, the features of recurrent infection in the same individual are defined poorly. To clarify the clinical significance of repeated HRSV infections in relation to subgroup epidemiology, this study performed prospective and longitudinal analyses in children with lower respiratory tract infections over 20 consecutive epidemics between 1985 and 2005 at a pediatric outpatient clinic in Kawasaki, Japan. HRSV infections were confirmed by 2 types of reverse-transcription PCR. Samples obtained from patients with repeated infections were subjected to sequence analysis and cloning analysis. A total of 1,312 lower respiratory tract infections observed in 1,010 patients were diagnosed as HRSV infections. Repeated HRSV infections occurred in 208 of the 1,010 patients. Analysis of the patients with repeated infections revealed that children were often infected multiple times even within a single short epidemic. Some patients were re-infected with strains having the same or virtually identical N gene sequences. In patients infected more than 4 times, cloning analysis revealed more frequent dual infections with both subgroups (23.8%). The HRSV-A subgroup caused subsequent homologous infections more frequently than did HRSV-B; furthermore, HRSV-A infections provided no protection from a second homologous infection. In contrast, HRSV-B infections offered significant protection against a second homologous infection. Statistical analysis revealed alleviation of symptoms with a reduced rate of dyspnoeic attacks only in the group re-infected with homologous HRSV-A strains. Thus, this study elucidates new clinical features of recurrent HRSV infection. J. Med. Virol 86: 1629–1638, 2014.

Conservation of G-Protein Epitopes in Respiratory Syncytial Virus (Group A) Despite Broad Genetic Diversity: Is Antibody Selection Involved in Virus Evolution?

“…Hence, it may be that hRSV reinfections are determined by short-lived (or weak) antibody responses rather than selection of antigenic variants. Indeed, recent studies have provided evidence that reinfections in children are caused almost as frequently by heterologous viruses as by viruses of the homologous antigenic group (46,47). In addition, although partial group-specific neutralizing responses were noted in very young children after hRSV infections, neutralization was reported to be equally effective against contemporary or historical viruses, suggesting no significant antigenic drift (48).…”

Cumulative incidence of post‐infection asthma or wheezing among young children clinically diagnosed with respiratory syncytial virus infection in the United States: A retrospective database analysis

“…In addition, the study was designed to evaluate patients with a first-time diagnosis of RSV or AW; however, it does not include recurrent AW episodes which are well recognized in other studies. 17,18 It is also not possible to determine the atopic status of the infants/children studied using Optum. The database has a lower percentage of younger patients than the US population as a whole; therefore, the study population may be under-represented.…”

Sero-Epidemiological Study of Respiratory Syncytial Virus

“…The wild-type viruses were isolated from patients with a positive result using the rapid RS kit (check RSV® SA Scientific, Inc. San Antonio, Texas/ USA), and subgroups A and B were identified by genomic analysis. We assessed the genetic variability of RSV subgroups by restriction fragments analysis of PCR products and/or nucleotide sequence determination of part of the N protein gene [16].…”