Department of Pediatric Infectious Diseases, La Paz University Hospital, 28046 Madrid, Spain.
Translational Research Network in Pediatric Infectious Diseases, 28009 Madrid, Spain.
Viruses. 2021 May 9;13(5):867. doi: 10.3390/v13050867.
The impact of respiratory virus infection in patients diagnosed with ataxia-telangiectasia (A-T) has not been well studied.
A prospective case control study was performed at a National Reference Unit for Primary Immunodeficiency in Spain (from November 2018 to July 2019), including patients younger than 20 years. Symptom questionnaires and nasopharyngeal swabs from multiple respiratory viruses' polymerase chain reaction were collected monthly, and between visits in case of symptoms.
Twenty-two individuals were included (11 patients; 11 controls); 164 samples were obtained (81 patients; 84 controls). Patients presented respiratory symptoms more frequently compared with controls (26.5% vs. 3.5%; < 0.01). Viral detection was observed in 23 (27.3%) episodes in patients and in 15 (17.8%) episodes in controls ( = 0.1). Rhinovirus was the most frequent virus in patients and controls (60% and 53.3%, respectively). Episodes with positive viral detection had associated symptoms in 54% of patients and 18% of controls ( = 0.07). However, patients with A-T presented a similar rate of symptoms during episodes with positive and negative viral detection (26% vs. 27%). The median points given for each questionnaire during symptomatic episodes with negative viral detection were 13/23 points, and during symptomatic positive detection, 7.5/23 points ( = 0.1). In the control group, all but two were asymptomatic during positive viral episodes (score: 2/23 and 3/23 points). Symptomatic episodes, with either positive or negative viral detection, were associated with lower IgA and higher IgM titers and higher CD8+ counts ( < 0.05), particularly when these episodes were moderate/severe.
Patients with A-T more frequently present symptomatic viral infections than controls, especially those with lower IgA and higher IgM titers and higher CD8+ counts.
呼吸道病毒感染对共济失调毛细血管扩张症（A-T）患者的影响尚未得到充分研究。
这是一项在西班牙国家原发性免疫缺陷参考单位（2018 年 11 月至 2019 年 7 月）进行的前瞻性病例对照研究，纳入了 20 岁以下的患者。每月收集症状问卷和鼻咽拭子进行多种呼吸道病毒聚合酶链反应检测，有症状时则在就诊之间进行检测。
共纳入 22 名患者（11 例患者；11 例对照），采集了 164 份样本（81 例患者；84 例对照）。与对照组相比，患者出现呼吸道症状的频率更高（26.5%比 3.5%；<0.01）。在患者中观察到 23 次（27.3%）发作中有病毒检测阳性，在对照组中观察到 15 次（17.8%）发作中有病毒检测阳性（=0.1）。鼻病毒是患者和对照组中最常见的病毒（分别为 60%和 53.3%）。在检测阳性的发作中，有症状的患者占 54%，有症状的对照者占 18%（=0.07）。然而，A-T 患者在病毒检测阳性和阴性的发作中出现症状的比例相似（26%比 27%）。在无病毒检测阳性的症状发作期间，每个问卷的中位数为 13/23 分，而在有症状的病毒检测阳性时为 7.5/23 分（=0.1）。在对照组中，所有患者在病毒检测阳性发作期间均无症状（评分：2/23 分和 3/23 分）。有症状的发作，无论病毒检测阳性或阴性，均与较低的 IgA 和较高的 IgM 滴度和较高的 CD8+计数有关（<0.05），尤其是当这些发作为中度/重度时。
与对照组相比，A-T 患者更常出现有症状的病毒感染，特别是那些 IgA 较低、IgM 较高和 CD8+计数较高的患者。
