Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Pará, Brazil.
Gaspar Vianna Clinic Hospital Foundation, Belém, Pará, Brazil.
BMC Pediatr. 2019 Aug 28;19(1):299. doi: 10.1186/s12887-019-1681-6.
Palivizumab prophylaxis for the human respiratory syncytial virus (HRSV) has been reported to reduce the risk of hospital admissions related to HRSV in children with congenital heart disease (CHD). These children are at high risk of developing severe lower respiratory tract infection (LRTI) due to HRSV infection. Our goal was to evaluate the incidence of HRSV infection in children with CHD after being submitted to immunoprophylaxis with palivizumab in Pará state, North region of Brazil.
A prospective and observational cohort study was performed in children ≤2 years of age with CHD who received palivizumab immunoprophylaxis between January 1 and June 31, 2016. A questionnaire about basic non-medical care measures was applied to parents/legal representatives. Data on patients' demographic characteristics, household environment, and respiratory infections were evaluated. HRSV infection was determined by qPCR.
There were 104 children enrolled in this investigation and the results showed a mean age of 10.6 months, an average weight of 7.3 kg and 3.5 doses of palivizumab per children during seasonality of HRSV. Respiratory infection was observed in 27.9% of cases, of which 9.6% were LRTI. No case of children who received palivizumab immunoprophylaxis and developed influenza-like symptoms tested positive for HRSV.
Although the lack of a control group doesn't allow to affirm the effectiveness of HRSV passive immunization, the immunoprophylaxis with palivizumab appeared to be totally efficient in preventing respiratory infection by HRSV in children up to two years of age with CHD.
已有研究报道,人类呼吸道合胞病毒(HRSV)的帕利珠单抗预防可降低患有先天性心脏病(CHD)的儿童因 HRSV 而住院的风险。这些儿童因 HRSV 感染而发生严重下呼吸道感染(LRTI)的风险较高。我们的目标是评估巴西北部帕拉州接受帕利珠单抗免疫预防的 CHD 儿童的 HRSV 感染发生率。
这是一项前瞻性观察队列研究,纳入了 2016 年 1 月 1 日至 6 月 31 日期间接受帕利珠单抗免疫预防的≤2 岁 CHD 儿童。向患儿父母/法定监护人发放了一份关于基本非医疗护理措施的调查问卷。评估了患儿的人口统计学特征、家庭环境和呼吸道感染数据。通过 qPCR 确定 HRSV 感染。
本研究共纳入 104 例患儿,结果显示患儿的平均年龄为 10.6 个月,平均体重为 7.3kg,每例患儿在 HRSV 流行季节接受 3.5 剂帕利珠单抗。27.9%的患儿出现呼吸道感染,其中 9.6%为 LRTI。未发现接受帕利珠单抗免疫预防且出现流感样症状的患儿的 HRSV 检测呈阳性。
尽管缺乏对照组不允许确定 HRSV 被动免疫的有效性,但帕利珠单抗免疫预防似乎可完全有效地预防 CHD 2 岁以下儿童的 HRSV 呼吸道感染。