Zhou Lili, Xiao Qiuyan, Zhao Yao, Huang Ailong, Ren Luo, Liu Enmei
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing, China.
Key Laboratory of Pediatrics in Chongqing CSTC2009CA5002, Chongqing, China.
J Med Virol. 2015 Aug;87(8):1276-84. doi: 10.1002/jmv.24111. Epub 2015 Apr 23.
The impact of dynamic respiratory syncytial virus (RSV) load on the clinical severity of hospitalized infants with bronchiolitis has not been clarified. Nasopharyngeal aspirates were obtained from 60 infants who were diagnosed with bronchiolitis within 96 hr of wheezing onset upon admission and on days 3, 5, and 7 in the hospital, and 17 respiratory viruses were detected. The RSV load was quantified by real-time qPCR for RSV subtypes A and B at different time points. Scoring criteria were used to evaluate the degree of severity. A total of 40 infants were determined to be RSV-positive, nine were identified as RSV subtype A (RSVA), and 31 were RSV subtype B (RSVB). The peak RSV load was observed upon admission, and the RSV load decreased significantly over time; in addition, this decrease began to have significant differences on day 5. There was a positive correlation between the RSV load and the clinical score (r(2) = 0.121 and P < 0.001). According to the clinical scores, the infants in the severe group tended to have higher RSV loads than those in the moderate and mild groups. Multivariate logistic regression models revealed that the viral load on day 3 was independently associated with the degree of severity. This study elucidated that a higher mean RSV load was associated with a more severe disease and a longer duration of hospitalization and symptoms. This study also clarified RSV replication in infants and provides a theoretical basis for specifying an anti-RSV therapy strategy.
动态呼吸道合胞病毒（RSV）载量对住院毛细支气管炎婴儿临床严重程度的影响尚未明确。对60例在入院喘息发作96小时内以及住院第3、5和7天被诊断为毛细支气管炎的婴儿采集鼻咽抽吸物，检测到17种呼吸道病毒。通过实时定量PCR对不同时间点的RSV A、B亚型进行RSV载量定量。采用评分标准评估严重程度。共有40例婴儿被确定为RSV阳性，其中9例为RSV A亚型（RSVA），31例为RSV B亚型（RSVB）。RSV载量在入院时达到峰值，且随时间显著下降；此外，这种下降在第5天开始出现显著差异。RSV载量与临床评分呈正相关（r(2) = 0.121，P < 0.001）。根据临床评分，重度组婴儿的RSV载量往往高于中度和轻度组。多因素逻辑回归模型显示，第3天的病毒载量与严重程度独立相关。本研究阐明，较高的平均RSV载量与更严重的疾病以及更长的住院时间和症状持续时间相关。本研究还明确了婴儿体内RSV的复制情况，为制定抗RSV治疗策略提供了理论依据。
