Dijkema Jasper S, van Ewijk Bart E, Wilbrink Berry, Wolfs Tom F W, Kimpen Jan L L, van der Ent Cornelis K
From the *Department of Pediatrics, Wilhelmina Children's Hospital, Utrecht, The Netherlands; †Department of Pediatrics, Tergooi Hospital, Blaricum, The Netherlands; ‡National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands; and §University Medical Centre Utrecht, Utrecht, The Netherlands. The authors have no conflicts of interest to disclose.
Pediatr Infect Dis J. 2016 Apr;35(4):379-83. doi: 10.1097/INF.0000000000001014.
Respiratory viral infections are an important cause of morbidity in patients with chronic respiratory diseases, such as cystic fibrosis (CF). We hypothesized that patients with CF are more susceptible to human rhinovirus (HRV) infections than healthy controls.
In a 6-month winter period, 20 young children with CF (0-7 years) and 18 age-matched healthy controls were sampled biweekly for HRV-polymerase chain reaction using nasopharyngeal swabs, irrespective of respiratory symptoms. Respiratory symptoms were scored twice a week. If any symptom was present, an additional sample was obtained. All HRV-positive samples were genotyped to distinguish HRV subtypes.
We analyzed 645 samples, with comparable total numbers of samples in both groups. HRV was detected in 40.8% of all analyzed samples. Children with CF had significantly more HRV-positive samples compared with healthy controls, with a mean number (± standard deviation) of 8.1 ± 2.3 versus 5.7 ± 2.9 positive samples per individual (P < 0.01). Prolonged detection (>2 weeks) with the same HRV subtype occurred more frequently in the CF patients (P < 0.01). The genetic distribution and pattern of phylogenetic diversity of the different HRV subtypes were similar in both groups.
This is the first in vivo longitudinal study showing that HRV is detected more frequently and persists for longer periods in CF patients compared with healthy controls. This might indicate increased viral replication and/or decreased antiviral defense in patients with CF.
呼吸道病毒感染是慢性呼吸道疾病患者发病的重要原因,如囊性纤维化(CF)。我们假设CF患者比健康对照更容易感染人鼻病毒(HRV)。
在为期6个月的冬季,每两周对20名CF患儿(0 - 7岁)和18名年龄匹配的健康对照进行采样,使用鼻咽拭子进行HRV聚合酶链反应检测,无论有无呼吸道症状。每周对呼吸道症状进行两次评分。如果出现任何症状,则额外采集样本。对所有HRV阳性样本进行基因分型以区分HRV亚型。
我们分析了645份样本,两组样本总数相当。在所有分析样本中,40.8%检测到HRV。与健康对照相比,CF患儿的HRV阳性样本显著更多,个体阳性样本的平均数(±标准差)分别为8.1±2.3和5.7±2.9(P < 0.01)。CF患者中同一HRV亚型的长期检测(>2周)更为频繁(P < 0.01)。两组中不同HRV亚型的基因分布和系统发育多样性模式相似。
这是第一项体内纵向研究,表明与健康对照相比,CF患者中HRV检测更频繁且持续时间更长。这可能表明CF患者病毒复制增加和/或抗病毒防御能力下降。