Mori Masaaki, Morio Tomohiro, Ito Shuichi, Morimoto Akira, Ota Setsuo, Mizuta Koichi, Iwata Tsutomu, Hara Toshiro, Saji Tsutomu
Yokohama City University Medical Center, Pediatrics, Japan.
Tokyo Medical and Dental University, Department of Pediatrics, Japan.
J Infect Chemother. 2014 Aug;20(8):455-9. doi: 10.1016/j.jiac.2014.05.001. Epub 2014 Jun 11.
By the age of two years, almost all infants are infected with the Respiratory syncytial virus (RSV). One of the main causes of hospitalizations for bronchiolitis and pneumonia at this age is RSV infection. In addition to well-known risks for severe RSV disease, such as prematurity, bronchopulmonary dysplasia and congenital heart disease, immunodeficiencies, chromosomal abnormalities such as Down's syndrome or neuromuscular diseases have also been identified as risks. While the medical needs for RSV prevention in these risk groups are high, clinical evidence to support this is limited. Palivizumab was recently approved in Japan for prophylaxis in children with immunodeficiency or Down's syndrome. A clinical guidance protocol for the prevention of RSV infection using Palivizumab in these risk groups is provided here on the basis of a review of the available literature and on expert opinion. Thus, the present article reviews the published literature related to RSV infections in infants and children with immunodeficiencies or Down's syndrome in order to outline the risks, pathology and physiology of severe RSV disease in these patient groups. The purpose of this article is to facilitate understanding of the medical scientific bases for the clinical guidance.
到两岁时，几乎所有婴儿都感染过呼吸道合胞病毒（RSV）。该年龄段毛细支气管炎和肺炎住院的主要原因之一是RSV感染。除了早产、支气管肺发育不良、先天性心脏病等已知的严重RSV疾病风险外，免疫缺陷、唐氏综合征等染色体异常或神经肌肉疾病也被确定为风险因素。虽然这些风险群体对RSV预防的医疗需求很高，但支持这一点的临床证据有限。帕利珠单抗最近在日本被批准用于免疫缺陷或唐氏综合征儿童的预防。本文基于对现有文献的综述和专家意见，提供了在这些风险群体中使用帕利珠单抗预防RSV感染的临床指导方案。因此，本文回顾了与免疫缺陷或唐氏综合征婴幼儿RSV感染相关的已发表文献，以概述这些患者群体中严重RSV疾病的风险、病理和生理情况。本文的目的是促进对临床指导的医学科学依据的理解。
