Respiratory Virus Infections in Children With Cancer or HIV Infection

Abstract

Most studies focusing on respiratory infections in immunocompromised children have been addressed to bacterial etiology. However, respiratory virus infections in this population can also lead to severe disease. The objective of this study is to evaluate the clinical significance of respiratory virus infections in children with cancer or human immunodeficiency virus (HIV) infection. Retrospective study conducted in a teaching hospital in Madrid. Medical records from children <or=14 years diagnosed with cancer or with HIV infection were reviewed. We analyzed demographic characteristics, clinical syndromes associated with the infection, need for hospitalization, treatment prescribed, and outcome. Fifty-three respiratory viral infections were identified: 26 (20%) in 129 HIV-infected children and 27 (12%) in 218 children with cancer. Twenty (38%) of the respiratory infections were nosocomial. Causal viruses were: respiratory syncytial virus, 43%; influenza A, 26%; adenovirus, 13%; parainfluenza virus, 13%; and influenza B, 4%. Thirty-three children were hospitalized: 14 (54%) with HIV infection and 19 (70%) receiving anticancer chemotherapy. Pneumonia occurred in 11 (34%) of the 33 hospitalized children. Four (21%) of the 19 hospitalized children with cancer, but none of the HIV-infected children, were admitted to the Pediatric Intensive Care Unit (P=0.096). Two children with cancer died. Common respiratory virus infections in children with cancer or HIV infection have a relevant morbidity. The fact that 40% of these infections are hospital-acquired emphasizes the need for isolation and preventive measures.

Frequency and Clinical Outcome of Respiratory Viral Infections and Mixed Viral-bacterial Infections in Children With Cancer, Fever and Neutropenia

“…6,9,[18][19][20] Most studies have focused on RVs, 21,22 suggesting that they tend to be more severe in immunocompromised patients. 23,24 In Chile, a previous study 21 3,26,27 in this study, were detected mostly as RV coinfections.…”

Epidemiology and outcomes of hospitalization of influenza in the cancer population in Taiwan

“…InXuenza is sometimes associated with malaise that persists for several weeks, which results in restriction of activity and accounts for millions of days lost from work each year (O'Reilly and Stevens 2002). InXuenza infections are more severe in patients with a signiWcant comorbid condition, such as cancer (Cooksley et al 2005;Mendoza Sánchez et al 2006). Consequently, inXuenza infection carries with it both signiWcant human and economic costs (Avritscher et al 2007).…”

Influenza vaccination in children with cancer receiving chemotherapy

“…10 In comparison with HIV-infected patients, children with cancer and influenza usually suffer from more complications and more frequently require intensive care. 10 Furthermore, the frequent development of complications means that influenza can significantly prolong the hospitalization of children requiring chemotherapy and considerably delay the start of drug administration. 9,11 Almost half of the children with cancer followed up by Tasian et al required oxygen supplementation for up to thirty days when infected by influenza viruses, and a proportion required hospitalization in an intensive care unit.…”

“…10 In comparison with HIV-infected patients, children with cancer and influenza usually suffer from more complications and more frequently require intensive care. 10 Furthermore, the frequent development of complications means that influenza can significantly prolong the hospitalization of children requiring chemotherapy and considerably delay the start of drug administration.…”