Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado 80045, USA.
Semin Respir Crit Care Med. 2011 Aug;32(4):447-53. doi: 10.1055/s-0031-1283284. Epub 2011 Aug 19.
Human metapneumovirus (hMPV) is a common pathogen that can cause both upper and lower respiratory tract infections, particularly in children, elderly adults, and immunocompromised hosts. Since its initial identification in 2001, hMPV has been isolated from individuals with acute respiratory tract infections (ARTIs) in virtually every continent. Serological studies indicate that it has caused human infection since 1958 or earlier. The epidemiology and clinical manifestations of hMPV are similar to those of the human respiratory syncytial virus (hRSV). HMPV has a seasonal variation: it circulates in late winter to early spring in temperate climates; late spring and summer in tropical regions. In young children, symptoms range from mild upper respiratory tract infections to severe lower respiratory tract infections (eg, bronchiolitis, croup, and pneumonia). In adults, hMPV reinfection typically presents with colds and flulike clinical manifestations. The disease is more severe (sometimes lethal) in immunocompromised hosts. Reverse transcription polymerase chain reaction (RT-PCR) is the most sensitive test with which to detect hMPV infection. Direct detection of hMPV antigens with an immunofluorescent antibody test is available but is less sensitive than PCR. Antibody testing is used mainly for retrospective diagnosis (≥ fourfold increase in titer or seroconversion) and for epidemiological studies. The mainstay of treatment of hMPV infections is supportive. Ribavirin has similar activity in vitro and in animal models against hRSV and hMPV, but its efficacy in vivo is unproven. Monoclonal antibodies have activity in murine models but are not available in humans. Several vaccines are promising in animal models, but their safety and efficacy have not yet been evaluated in humans.
人偏肺病毒（hMPV）是一种常见的病原体，可引起上呼吸道和下呼吸道感染，尤其在儿童、老年人和免疫功能低下者中较为常见。自 2001 年首次发现以来，hMPV 已从几乎各大洲的急性呼吸道感染（ARTI）患者中分离出来。血清学研究表明，自 1958 年或更早以前，hMPV 就已引起人类感染。hMPV 的流行病学和临床表现与人类呼吸道合胞病毒（hRSV）相似。hMPV 呈季节性变化：在温带气候中，它于冬末春初流行；在热带地区，于春末夏初流行。在幼儿中，症状从轻度上呼吸道感染到严重下呼吸道感染（如细支气管炎、哮吼和肺炎）不等。在成人中，hMPV 再感染通常表现为感冒和流感样临床表现。在免疫功能低下者中，疾病更为严重（有时甚至致命）。逆转录聚合酶链反应（RT-PCR）是检测 hMPV 感染最敏感的方法。免疫荧光抗体试验直接检测 hMPV 抗原，但敏感性低于 PCR。抗体检测主要用于回顾性诊断（滴度≥四倍升高或血清转换）和流行病学研究。hMPV 感染的主要治疗方法是支持治疗。利巴韦林在体外和动物模型中对 hRSV 和 hMPV 具有相似的活性，但在体内的疗效尚未得到证实。单克隆抗体在鼠模型中具有活性，但在人类中不可用。几种疫苗在动物模型中很有前景，但尚未在人类中评估其安全性和疗效。
