Espinosa Yazmín, San Martín Camila, Torres Alejandro A, Farfán Mauricio J, Torres Juan P, Avadhanula Vasanthi, Piedra Pedro A, Tapia Lorena I
Department of Pediatrics and Pediatric Surgery, Hospital Roberto del Río, Facultad de Medicina, Universidad de Chile, Profesor Zañartu 1085, Independencia, 8380418 Santiago, Chile.
Virology Program, Institute of Biomedical Sciences (ICBM), Facultad de Medicina, Universidad de Chile, Independencia 1027, Pabellón J. Independencia, 8380453 Santiago, Chile.
Int J Mol Sci. 2017 Mar 21;18(3):654. doi: 10.3390/ijms18030654.
The clinical impact of viral factors (types and viral loads) during respiratory syncytial virus (RSV) infection is still controversial, especially regarding newly described genotypes. In this study, infants with RSV bronchiolitis were recruited to describe the association of these viral factors with severity of infection. RSV antigenic types, genotypes, and viral loads were determined from hospitalized patients at Hospital Roberto del Río, Santiago, Chile. Cases were characterized by demographic and clinical information, including days of lower respiratory symptoms and severity. A total of 86 patients were included: 49 moderate and 37 severe cases. During 2013, RSV-A was dominant (86%). RSV-B predominated in 2014 (92%). Phylogenetic analyses revealed circulation of GA2, Buenos Aires (BA), and Ontario (ON) genotypes. No association was observed between severity of infection and RSV group ( = 0.69) or genotype ( = 0.87). After a clinical categorization of duration of illness, higher RSV genomic loads were detected in infants evaluated earlier in their disease ( < 0.001) and also in infants evaluated later, but coursing a more severe infection ( = 0.04). Although types and genotypes did not associate with severity in our children, higher RSV genomic loads and delayed viral clearance in severe patients define a group that might benefit from new antiviral therapies.
呼吸道合胞病毒(RSV)感染期间病毒因素(类型和病毒载量)的临床影响仍存在争议,尤其是对于新描述的基因型。在本研究中,招募了患有RSV细支气管炎的婴儿,以描述这些病毒因素与感染严重程度之间的关联。从智利圣地亚哥罗伯托·德尔·里奥医院的住院患者中确定了RSV抗原类型、基因型和病毒载量。病例以人口统计学和临床信息为特征,包括下呼吸道症状的天数和严重程度。共纳入86例患者:49例中度病例和37例重度病例。2013年,RSV-A占主导(86%)。2014年RSV-B占主导(92%)。系统发育分析显示GA2、布宜诺斯艾利斯(BA)和安大略(ON)基因型在流行。未观察到感染严重程度与RSV组(P = 0.69)或基因型(P = 0.87)之间存在关联。在对疾病持续时间进行临床分类后,在疾病早期接受评估的婴儿中检测到更高的RSV基因组载量(P < 0.001),在疾病后期接受评估但感染更严重的婴儿中也检测到更高的RSV基因组载量(P = 0.04)。尽管在我们的研究对象中病毒类型和基因型与严重程度无关,但重度患者中更高的RSV基因组载量和病毒清除延迟定义了一个可能从新抗病毒治疗中获益的群体。