Department of Neonatology, KK Women's & Children's Hospital, Singapore.
Duke-NUS Medical School, Singapore.
J Infect Dis. 2021 Jul 15;224(2):279-287. doi: 10.1093/infdis/jiaa749.
The year-round respiratory syncytial virus (RSV) circulation in tropical regions leads to different transmission patterns and burden of disease among infants born very preterm.
We conducted a retrospective cohort study to estimate the effectiveness of palivizumab in preventing RSV hospitalization at 6 and 12 months after discharge, among infants born at <32 weeks' gestation in our tropical setting.
A total of 109 infants (26.3%) received palivizumab at discharge, of 415 who were eligible. All patients received ≥4 doses, with 105 infants (96.3%) completing 5 doses. Within 1 year after discharge, there were 35 RSV-associated admissions (3 [2.8%] in the palivizumab vs 32 [10.5%] in the nonpalivizumab group; P = .02). After adjustment for confounders, the effectiveness of palivizumab against RSV hospitalization was estimated to be 90% (95% confidence interval, 10%-99%) up to 6 months after discharge. The median time to RSV hospitalization was shorter in the nonpalivizumab than in the palivizumab group (median [range], 155 [15-358] vs 287 [145-359] days, respectively; P = .11). Five infants (14.3%), all from the nonpalivizumab group, required admission to the intensive care unit.
In our setting with year-round RSV circulation, palivizumab prophylaxis was effective in reducing RSV hospitalization among high-risk preterm infants of <32 weeks' gestation within the initial 6 months after discharge.
在热带地区，呼吸道合胞病毒（RSV）全年流行，导致极早产儿的传播模式和疾病负担有所不同。
我们进行了一项回顾性队列研究，以评估在我们的热带环境中，对于妊娠 32 周以下的早产儿，出院时使用帕利珠单抗预防 RSV 住院的效果，评估 6 个月和 12 个月后 RSV 住院的效果。
共有 109 名（26.3%）符合条件的婴儿在出院时接受了帕利珠单抗治疗，其中 415 名婴儿接受了帕利珠单抗治疗。所有患者均接受了≥4 剂治疗，其中 105 名（96.3%）完成了 5 剂治疗。出院后 1 年内，共有 35 名 RSV 相关住院患儿（帕利珠单抗组 3 例[2.8%]，非帕利珠单抗组 32 例[10.5%]；P=0.02）。在调整混杂因素后，帕利珠单抗预防 RSV 住院的有效性估计为 90%（95%置信区间，10%-99%），直至出院后 6 个月。非帕利珠单抗组的 RSV 住院中位时间短于帕利珠单抗组（中位数[范围]，155[15-358]天与 287[145-359]天，P=0.11）。5 名婴儿（14.3%），均来自非帕利珠单抗组，需要入住重症监护病房。
在我们的环境中，RSV 全年流行，对于妊娠 32 周以下的高危早产儿，出院时使用帕利珠单抗预防 RSV 可在出院后最初 6 个月内有效降低 RSV 住院率。
