Department of Pediatrics, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Allergy and Clinical Immunology Unit, Pediatric Department, Al-Sabah Hospital, Kuwait City, Kuwait.
Front Immunol. 2019 May 29;10:1231. doi: 10.3389/fimmu.2019.01231. eCollection 2019.
To present the frequency and spectrum of viral infections in primary immunodeficient children. The data was obtained from the Kuwait National Primary Immunodeficiency Disorders (PIDs) Registry during the period of 2004-2018. A total of 274 PID children were registered in KNPIDR during the study period with predominance of immunodeficiencies affecting cellular and humoral immunity, followed by combined immunodeficiencies with associated syndromic features and diseases of immune dysregulation. Overall infectious complications affected 82.4% of the patients, and viral infections affected 31.7% of the registered patients. Forty-five patients (16.4%) developed viral infections caused by at least 2 organisms, among those 20 patients were affected by three or more viral infections. There was a statistically significant association between viral infections and PID category. However, there was no statistically significant association between viral infections and gender or the patients' onset age. There was a total of 170 viral infections during the study period and the causes of these infections were predominated by CMV (22.2%), adenovirus (11.7%), EBV (11.1%), and enteroviruses (7.4%). CMV and parainfluenza infections were more common in the group of immunodeficiencies affecting cellular and humoral immunity while EBV and human papilloma virus (HPV) were more common in the immune dysregulation group and combined immunodeficiencies with associated syndromic features, respectively. The most common presentation was viremia (28.8%) followed by pneumonia (28.2%) and skin infections (17.6%). The most common causes of viremia were CMV followed by adenovirus and EBV, while the most common organisms causing pneumonia were CMV followed by rhinovirus and parainfluenza. There were 80 deaths among the registered patients, 10% were caused by viral infections. Viral infections are common in PIDs and result into a wide-range of clinical manifestations causing significant morbidity and mortality.
介绍原发性免疫缺陷儿童病毒感染的频率和谱。数据来自 2004 年至 2018 年期间科威特国家原发性免疫缺陷疾病（PID）登记处。在研究期间，KNPIDR 共登记了 274 名 PID 儿童，其中以影响细胞和体液免疫的免疫缺陷为主，其次是伴有综合征特征和免疫失调相关疾病的联合免疫缺陷。总体感染并发症影响了 82.4%的患者，病毒感染影响了登记患者的 31.7%。45 名患者（16.4%）发生了至少由 2 种病原体引起的病毒感染，其中 20 名患者受到 3 种或更多种病毒感染的影响。病毒感染与 PID 类别之间存在统计学显著关联。然而，病毒感染与性别或患者发病年龄之间无统计学显著关联。研究期间共发生 170 例病毒感染，这些感染的病原体以 CMV（22.2%）、腺病毒（11.7%）、EBV（11.1%）和肠道病毒（7.4%）为主。CMV 和副流感病毒感染在影响细胞和体液免疫的免疫缺陷组中更为常见，而 EBV 和人乳头瘤病毒（HPV）在免疫失调组和伴有综合征特征的联合免疫缺陷中更为常见。最常见的表现是病毒血症（28.8%），其次是肺炎（28.2%）和皮肤感染（17.6%）。病毒血症最常见的病原体是 CMV，其次是腺病毒和 EBV，而引起肺炎最常见的病原体是 CMV，其次是鼻病毒和副流感病毒。在登记的患者中有 80 人死亡，其中 10%是由病毒感染引起的。病毒感染在 PID 中很常见，导致广泛的临床表现，造成严重的发病率和死亡率。
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