Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York 14621, USA.
Semin Respir Crit Care Med. 2011 Aug;32(4):423-32. doi: 10.1055/s-0031-1283282. Epub 2011 Aug 19.
Respiratory syncytial virus (RSV), an enveloped RNA virus in the Paramyxovirus family, is the most important cause of lower respiratory tract infection in infants and young children, accounting for ~100,000 pediatric hospitalizations and 250 deaths annually in the United States. Despite primarily being recognized as a pediatric pathogen, RSV reinfection causes substantial disease in all adult populations, including healthy young persons, old and frail individuals, those with chronic obstructive pulmonary disease and immunocompromised patients. Most illnesses are mild in adults, but significant morbidity and mortality can develop. In contrast to infants, diagnosis of RSV infections is difficult due to low virus shedding, and optimal diagnosis requires molecular tests. Unfortunately, antiviral therapy is of limited benefit. Ribavirin and palivizumab are the only approved pharmacological agents for RSV treatment and prophylaxis, respectively, and are primarily used in infants; data regarding their usefulness in adults are limited. Currently, specific antiviral therapy is generally reserved for severely immunocompromised patients or severe respiratory failure. The greatest promise for reducing the impact of RSV in adults may be through immunization. However, an effective vaccine for RSV is not currently available.
呼吸道合胞病毒（RSV）是副黏液病毒科的有包膜 RNA 病毒，是导致婴幼儿下呼吸道感染的最重要原因，每年导致美国约 10 万例儿科住院治疗和 250 例死亡。尽管 RSV 主要被认为是一种儿科病原体，但在所有成年人群体中，包括健康的年轻人、年老体弱的个体、慢性阻塞性肺疾病患者和免疫功能低下的患者中，RSV 再感染都会引起严重疾病。大多数成年人的疾病症状较轻，但也可能会出现严重的发病率和死亡率。与婴儿不同，由于病毒排出量低，RSV 感染的诊断较为困难，最佳诊断需要进行分子检测。不幸的是，抗病毒治疗的效果有限。利巴韦林和帕利珠单抗分别是 RSV 治疗和预防的唯一批准的药物，主要用于婴儿；关于它们在成年人中有效性的数据有限。目前，特定的抗病毒治疗通常仅保留给严重免疫功能低下的患者或严重呼吸衰竭的患者。通过免疫接种来减轻 RSV 对成年人影响的前景可能最大。然而，目前还没有有效的 RSV 疫苗。
