The Clinical Impact of Human Respiratory Virus Infections

Denny, Floyd W.

doi:10.1164/ajrccm/152.4_pt_2.s4

Cited by 142 publications

(102 citation statements)

References 32 publications

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“…More importantly, pathology follow-up surveillance data during 18 months after the parainfluenza virus infection revealed that 32% of the lung transplant recipients developed active bronchiolitis obliterans (OB) (13). The median time between the parainfluenza virus infection and the development of OB was 6 months (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. This is a very important finding because OB is considered the single most important limitation to long-term survival after lung transplantation with an incidence of 41% to 63% at 5 years post-transplant (31).…”

Section: Allograft Complicationsmentioning

confidence: 99%

“…The spectrum of the disease in children ranges from a mild cold to croup, bronchiolitis and viral pneumonia. In adults these infections are usually mild and restricted to the upper respiratory tract (5). However, recent studies of the viral etiology of acute lower respiratory tract infections in adults indicate that parainfluenza virus accounts for 2.5 to 11.5% of hospitalized adult patients (6,7).…”

Section: Introductionmentioning

confidence: 99%

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Parainfluenza Virus Infection in Adult Lung Transplant Recipients: An Emergent Clinical Syndrome with Implications on Allograft Function

Vilchez

Dauber

McCurry

et al. 2003

American Journal of Transplantation

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Parainfluenza virus is a common cause of seasonal upper respiratory tract infections in children and adults. Studies indicate that parainfluenza virus may play an important role in the etiology of respiratory tract infections in lung transplant recipients with an estimated incidence of 5.3 per 100 patients. Parainfluenza virus type 3 is the most frequent serotype in lung transplant patients. The rate of lower respiratory tract infections with parainfluenza virus among lung transplant recipients is between 10 and 66% of cases. In addition, trans-bronchial biopsy at the time of parainfluenza infection shows signs of acute allograft rejection. Subsequently, 32% of patients have been found to have active bronchiolitis obliterans at a median time of 6 months (range 1-14) postviral infection. These findings indicate that parainfluenza virus infections may have long-term implications for lung transplant recipients. Further studies are required to identify the mechanisms of immunomodulation of parainfluenza virus among these patients. In addition, controlled studies are needed to evaluate the efficacy of aerosolized ribavarin in the treatment of parainfluenza virus infection and to determine whether vaccines may be effective in these high-risk patients.

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Section: Allograft Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Parainfluenza Virus Infection in Adult Lung Transplant Recipients: An Emergent Clinical Syndrome with Implications on Allograft Function

Vilchez

Dauber

McCurry

et al. 2003

American Journal of Transplantation

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“…Human rhinoviruses are the most common viral infectious agents in humans (9). In the United States, rhinoviruses account for more than one billion cases annually of viral respiratory tract infections (VRTI; i.e., the common cold) (34).…”

mentioning

confidence: 99%

VP1 Sequencing of All Human Rhinovirus Serotypes:Insights into Genus Phylogeny and Susceptibility to AntiviralCapsid-BindingCompounds

Ledford¹,

Patel²,

Demenczuk³

et al. 2004

J Virol

195

209

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Rhinoviruses are the most common infectious agents of humans. They are the principal etiologic agents of afebrile viral upper-respiratory-tract infections (the common cold). Human rhinoviruses (HRVs) comprise a genus within the family Picornaviridae. There are >100 serotypically distinct members of this genus. In order to better understand their phylogenetic relationship, the nucleotide sequence for the major surface protein of the virus capsid, VP1, was determined for all known HRV serotypes and one untyped isolate (HRV-Hanks). Phylogenetic analysis of deduced amino acid sequence data support previous studies subdividing the genus into two species containing all but one HRV serotype (HRV-87). Seventy-five HRV serotypes and HRV-Hanks belong to species HRV-A, and twenty-five HRV serotypes belong to species HRV-B. Located within VP1 is a hydrophobic pocket into which small-molecule antiviral compounds such as pleconaril bind and inhibit functions associated with the virus capsid. Analyses of the amino acids that constitute this pocket indicate that the sequence correlates strongly with virus susceptibility to pleconaril inhibition. Further, amino acid changes observed in reduced susceptibility variant viruses recovered from patients enrolled in clinical trials with pleconaril were distinct from those that confer natural phenotypic resistance to the drug. These observations suggest that it is possible to differentiate rhinoviruses naturally resistant to capsid function inhibitors from those that emerge from susceptible virus populations as a result of antiviral drug selection pressure based on sequence analysis of the drug-binding pocket.Human rhinoviruses are the most common viral infectious agents in humans (9). In the United States, rhinoviruses account for more than one billion cases annually of viral respiratory tract infections (VRTI; i.e., the common cold) (34). The National Center for Health Statistics estimated that in 1996, 62 million cases of the common cold required medical attention or resulted in restricted activity in the United States (33). During this period, colds caused 45 million days of restricted activities and 22 million days lost from school. Roughly one in six colds results in a doctor's office visit, and up to 50% of these visits result in an antibiotic prescription (15,29,35,47). In 1998, more antibiotic prescriptions were written for presumed VRTIs than for bacterial infections, at a cost of approximately $726 million (14). Such inappropriate antibiotic prescribing is a major contributing factor to the development of drug-resistant bacterial pathogens (4,28,35,48). The total economic impact of non-influenza-related VRTI in terms of both direct (health care resource use) and indirect (productivity loss) costs approaches $40 billion annually (11).HRVs comprise a genus within the family Picornaviridae. Picornaviruses are small, nonenveloped viruses containing a single strand of message sense RNA. The RNA is protected by a protein coat or capsid composed of 60 copies of each of four structur...

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“…In some samples, a common wildtype respiratory virus (RSV, PIV1, PIV2, PIV3, influenza A or B virus, enterovirus, HRV, or adenovirus) was identified as a probable etiologic agent; however, no viruses were detected in more than three quarters of illness samples. Although most respiratory illnesses are caused by viruses (6), some of these illnesses may be caused by other pathogens, such as Streptococcus pyogenes, Mycoplasma pneumoniae, Streptococcus pneumoniae, nonencapsulated Haemophilus influenzae, Chlamydia pneumoniae, and Moraxella catarrhalis.…”

mentioning

confidence: 99%

Comparison of Results of Detection of Rhinovirus by PCR and Viral Culture in Human Nasal Wash Specimens from Subjects with and without Clinical Symptoms of Respiratory Illness

et al. 2007

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Human rhinoviruses (HRV) cause acute upper respiratory illness. The frequency of HRV-associated illnesses appears greater when PCR assays are used to detect rhinoviruses. The present study performed PCR-based detection of HRV upon entry of subjects into respiratory syncytial virus and parainfluenza type 3 vaccine trials when subjects were symptom-free and upon subsequent development of clinical symptoms of respiratory illness during the trial. The background of HRV PCR positivity in symptom-free individuals (30/139 [22%]) was only slightly lower than in those with respiratory illness (28/77 [36%]). For subjects with multiple samples, it was estimated that HRV was detectable by PCR for approximately 100 days before, during, and after clinical symptoms were documented. PCR is a remarkably more sensitive method of detecting HRV than is tissue culture. The presence of HRV RNA may not always reflect an association with infectious virus production. The limited association of HRV RNA with illness suggests caution in assigning causality of HRV PCR positivity to clinical symptoms of respiratory illness.Over 100 serotypes of human rhinoviruses (HRV), members of the family Picornaviridae, have been identified through community surveillance of respiratory illness (19). HRV has traditionally been identified by growth in tissue culture, as characterized by cytopathic effect. HRV are differentiated from enteroviruses by the capacity to grow at 33°C and acid lability. HRV are responsible for a substantial proportion of upper respiratory illnesses (19). Because infectious HRV are difficult to recover from clinical samples, it has been postulated that HRV may be responsible for other respiratory illnesses currently of unknown etiology (1,8,18,24). The fact that less than 1 50% tissue culture infectious dose of HRV caused an experimental human rhinovirus infection (5) suggests that tissue culture may not efficiently detect HRV. Recent reports suggest that PCR detection extends the scope of HRV illness to include lower respiratory tract illness (10) and establishes a strong association between rhinovirus and exacerbations of asthma (12,26). HRV has been shown to replicate in cells of both the upper (14, 27) and lower (21) respiratory tracts and can grow at the higher temperature of the lower respiratory tract (22).However, more limited studies have detected HRV by PCR in 12 to 20% of asymptomatic children and in a relatively high percentage of adenoid and tonsillar tissues, suggesting that identification of HRV by PCR may not necessarily confirm it as the etiologic agent (16,20,23,25). Identification of rhinovirus infection by PCR may not be accompanied by a serologic response, an unusual occurrence with most symptomatic respiratory viral infections (4).Clinical studies evaluating the safety of live, attenuated strains of respiratory syncytial virus (RSV) (17, 29) and parainfluenza virus type 3 (PIV3) (3) have recently been carried out with adults and children as young as 4 weeks of age. Nasal wash samples were collected from sympt...

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The Clinical Impact of Human Respiratory Virus Infections

Cited by 142 publications

References 32 publications

Parainfluenza Virus Infection in Adult Lung Transplant Recipients: An Emergent Clinical Syndrome with Implications on Allograft Function

Parainfluenza Virus Infection in Adult Lung Transplant Recipients: An Emergent Clinical Syndrome with Implications on Allograft Function

VP1 Sequencing of All Human Rhinovirus Serotypes:Insights into Genus Phylogeny and Susceptibility to AntiviralCapsid-BindingCompounds

Comparison of Results of Detection of Rhinovirus by PCR and Viral Culture in Human Nasal Wash Specimens from Subjects with and without Clinical Symptoms of Respiratory Illness

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