Correlation of rhinovirus load in the respiratory tract and clinical symptoms in hospitalized immunocompetent and immunocompromised patients

• Published in: Journal of medical virology Vol. 81; no. 8; pp. 1498 - 1507
• Main Authors: Gerna, G, Piralla, A, Rovida, F, Rognoni, V, Marchi, A, Locatelli, F, Meloni, F
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.08.2009; Wiley
• Subjects: Adult; Biological and medical sciences; bronchoalveolar lavage; Bronchoalveolar Lavage Fluid - virology; Child; Child, Preschool; Fundamental and applied biological sciences. Psychology; Genotype; Hospitalization; human rhinovirus load; Human viral diseases; Humans; Immunocompromised Host; immunocompromised patients; Infant; Infectious diseases; Medical sciences; Microbiology; Middle Aged; Miscellaneous; nasopharyngeal aspirates; Nasopharynx - virology; Picornaviridae Infections - pathology; Picornaviridae Infections - virology; Respiratory System - virology; respiratory tract infections; Respiratory Tract Infections - pathology; Respiratory Tract Infections - virology; Reverse Transcriptase Polymerase Chain Reaction - methods; Rhinovirus - isolation & purification; Viral diseases; Virology; Young Adult; Human; Immunopathology; Correlation; nasopharyngeal aspirates; Picornaviridae; Respiratory disease; human rhinovirus load; Hospitalization; Nasopharynx; Immune deficiency; Human rhinovirus; Virus; Respiratory tract; respiratory tract infections; Immunosuppression; Bronchoalveolar lavage; immunocompromised patients; Rhinovirus
• ISSN: 0146-6615; 1096-9071; 1096-9071
• DOI: 10.1002/jmv.21548

While human rhinoviruses (HRVs) are well accepted as a major cause of common cold syndromes (rhinitis), their role in the etiology of lower respiratory tract infections is still controversial, and their detection in asymptomatic patients is relatively common. The HRV pathogenic role in four groups of hospitalized patients (pediatric immunocompetent and immunocompromised patients, and adult immunocompetent and immunocompromised patients) was investigated by quantifying HRV load in nasopharyngeal aspirates or bronchoalveolar lavage samples by real-time reverse transcription PCR (RT-PCR). Real-time RT-PCR was performed in duplicate on all respiratory samples resulting positive by qualitative RT-PCR. In addition, molecular typing allowed detection of all known HRV species (A, B, and C). In immunocompetent pediatric patients HRVs were mostly associated with lower respiratory tract infections (in the absence of other viral agents) and wheezing, when viral load was greater-than-or-equal10⁶ RNA copies/ml. In young immunocompromised patients (stem cell transplantation recipients), an inverse correlation between HRV persistence over time and time at which the infection occurred after transplantation was observed, whereas in adult immunocompromised patients (lung transplant recipients) HRVs could be detected at a medium-low level (<10⁵ RNA copies/ml) in bronchoalveolar lavage samples taken routinely from asymptomatic patients. In conclusion, when detected at high viral load, HRVs may cause severe upper and lower respiratory tract infections, whereas when detected at a medium-low viral load, an event more frequent in immunocompromised subjects, they may represent only bystander viruses. J. Med. Virol. 81:1498-1507, 2009.