Barcelona Centre for International Health Research, (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain.
PLoS One. 2013 Jul 31;8(7):e69370. doi: 10.1371/journal.pone.0069370. Print 2013.
Although association between respiratory syncytial virus infection and later asthma development has been established, little is known about the role of other respiratory viruses. Rhinovirus was considered a mild pathogen of the upper respiratory tract but current evidence suggests that rhinovirus is highly prevalent among children with lower respiratory tract infections (LRTI). The aim of the study was to evaluate whether LRTI hospitalization associated with rhinovirus during infancy was associated with an increased risk of wheezing - a proxy measure of asthma - during childhood.
During a 12 months period, all infants <1 year admitted to Manhiça District Hospital with symptoms of LRTI who survived the LRTI episode, were enrolled in the study cohort. Nasopharyngeal aspirates were collected on admission for viral determination and study infants were classified according to presence or not of rhinovirus. The study cohort was passively followed-up at the Manhiça District Hospital for up to 4 years and 9 months to evaluate the association between LRTI associated with rhinovirus in infancy and wheezing during childhood.
A total of 220 infants entered the cohort; 25% of them had rhinovirus detected during the LRTI episode as opposed to 75% who tested negative for rhinovirus. After adjusting for sex and age and HIV infection at recruitment, infants hospitalized with LRTI associated with rhinovirus had higher incidence of subsequent visits with wheezing within the year following hospitalization [Rate ratio=1.68, (95% confidence interval=1.02-2.75); Wald test p-value = 0.039]. No evidence of increased incidence rate of visits with wheezing was observed for the remaining follow-up period. Our data suggest a short term increased risk of wheezing after an initial episode of LRTI with RV.
虽然呼吸道合胞病毒感染与哮喘发展之间存在关联已得到证实，但对于其他呼吸道病毒的作用知之甚少。鼻病毒被认为是上呼吸道的轻度病原体，但目前的证据表明，鼻病毒在患有下呼吸道感染（LRTI）的儿童中高度流行。本研究旨在评估婴儿期因鼻病毒引起的 LRTI 住院是否与儿童期喘息（哮喘的替代指标）风险增加相关。
在 12 个月的时间内，所有因 LRTI 症状而入住马希卡区医院且存活下来的 1 岁以下婴儿均纳入研究队列。在入院时采集鼻咽抽吸物进行病毒检测，并根据是否存在鼻病毒对研究婴儿进行分类。研究队列在马希卡区医院进行被动随访，最长可达 4 年零 9 个月，以评估婴儿期与鼻病毒相关的 LRTI 与儿童期喘息之间的关联。
共有 220 名婴儿进入队列；25%的婴儿在 LRTI 发作期间检测到鼻病毒，而 75%的婴儿检测结果为鼻病毒阴性。在调整性别、年龄和招募时的 HIV 感染后，因 LRTI 与鼻病毒相关而住院的婴儿在住院后一年内因喘息而再次就诊的发生率更高[率比=1.68，（95%置信区间=1.02-2.75）；Wald 检验 p 值=0.039]。在其余随访期间，未观察到喘息就诊发生率增加的证据。我们的数据表明，在初始 LRTI 后，RV 会导致短期喘息风险增加。
