University of Rouen Normandy, Dynamicure INSERM UMR 1311, CHU Rouen, Department of Pediatrics and Adolescent Medicine, Rouen, France.
University of Caen Normandy, Dynamicure INSERM UMR 1311, Centre hospitalo-universitaire (CHU) Caen, Department of Virology, Caen, France.
Front Cell Infect Microbiol. 2024 May 13;14:1380855. doi: 10.3389/fcimb.2024.1380855. eCollection 2024.
Acute respiratory infections (ARI) are the most common infections in the general population and are mainly caused by respiratory viruses. Detecting several viruses in a respiratory sample is common. To better understand these viral codetections and potential interferences, we tested for the presence of viruses and developed quantitative PCR (Polymerase Chain Reaction) for the viruses most prevalent in coinfections: human rhinovirus (HRV) and respiratory syncytial virus (RSV), and quantified their viral loads according to coinfections and health status, age, cellular abundance and other variables.
Samples from two different cohorts were analyzed: one included hospitalized infants under 12 months of age with acute bronchiolitis (n=719) and the other primary care patients of all ages with symptoms of ARI (n=685). We performed Multiplex PCR on nasopharyngeal swabs, and quantitative PCR on samples positive for HRV or/and RSV to determine viral loads (VL). Cellular abundance (CA) was also estimated by qPCR targeting the GAPDH gene. Genotyping was performed either directly from first-line molecular panel or by PCR and sequencing for HRV.
The risks of viral codetection were 4.1 (IC[1.8; 10.0]) and 93.9 1 (IC[48.7; 190.7]) higher in infants hospitalized for bronchiolitis than in infants in primary care for RSV and HRV respectively (p<0.001). CA was higher in samples positive for multiple viruses than in mono-infected or negative samples (p<0.001), and higher in samples positive for RSV (p<0.001) and HRV (p<0.001) than in negative samples. We found a positive correlation between CA and VL for both RSV and HRV. HRV VL was higher in children than in the elderly (p<0.05), but not RSV VL. HRV VL was higher when detected alone than in samples coinfected with RSV-A and with RSV-B. There was a significant increase of RSV-A VL when codetecting with HRV (p=0.001) and when co-detecting with RSV-B+HRV versus RSV-A+ RSV-B (p=0.02).
Many parameters influence the natural history of respiratory viral infections, and quantifying respiratory viral loads can help disentangle their contributions to viral outcome.
急性呼吸道感染（ARI）是普通人群中最常见的感染，主要由呼吸道病毒引起。在呼吸道样本中同时检测到几种病毒的情况很常见。为了更好地了解这些病毒的共同检测和潜在干扰，我们检测了病毒的存在，并针对最常见的合并感染病毒（人鼻病毒[HRV]和呼吸道合胞病毒[RSV]）开发了定量 PCR（聚合酶链反应），并根据合并感染和健康状况、年龄、细胞丰度和其他变量对病毒载量进行定量。
对两个不同队列的样本进行了分析：一个队列包括 719 名 12 个月以下因急性细支气管炎住院的婴儿，另一个队列包括所有年龄段因急性呼吸道感染症状就诊的患者。我们对鼻咽拭子进行多重 PCR 检测，对 HRV 和/或 RSV 阳性样本进行定量 PCR 以确定病毒载量（VL）。细胞丰度（CA）也通过针对 GAPDH 基因的 qPCR 进行估计。HRV 的基因分型直接从一线分子面板或通过 PCR 和测序进行。
与初级保健中因 RSV 和 HRV 就诊的婴儿相比，因细支气管炎住院的婴儿发生病毒共同检测的风险分别高 4.1（IC[1.8；10.0]）和 93.9 倍（IC[48.7；190.7]）（p<0.001）。与单感染或阴性样本相比，多重病毒阳性样本的 CA 更高（p<0.001），与阴性样本相比，RSV（p<0.001）和 HRV（p<0.001）阳性样本的 CA 更高。我们发现 CA 与 RSV 和 HRV 的 VL 呈正相关。与老年人相比，儿童的 HRV VL 更高（p<0.05），但 RSV VL 没有差异。与 RSV-A 单独检测相比，RSV-A 和 HRV 共同检测时 HRV VL 更高。与 RSV-B+HRV 相比，RSV-A+RSV-B 共同检测时 RSV-A VL 显著增加（p=0.001）。
许多参数影响呼吸道病毒感染的自然史，定量检测呼吸道病毒载量有助于理清它们对病毒结局的贡献。
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