Document Detail


Host and viral factors associated with severity of human rhinovirus-associated infant respiratory tract illness.
MedLine Citation:
PMID:  21269669     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Risk factors for severe human rhinovirus (HRV)-associated infant illness are unknown.
OBJECTIVES: We sought to examine the role of HRV infection in infant respiratory tract illness and assess viral and host risk factors for HRV-associated disease severity.
METHODS: We used a prospective cohort of term, previously healthy infants enrolled during an inpatient or outpatient visit for acute upper or lower respiratory tract illness during the fall-spring months of 2004-2008. Illness severity was determined by using an ordinal bronchiolitis severity score, with higher scores indicating more severe disease. HRV was identified by means of real-time RT-PCR. The VP4/VP2 region from HRV-positive specimens was sequenced to determine species.
RESULTS: Of 630 infants with bronchiolitis or upper respiratory tract illnesses (URIs), 162 (26%) had HRV infection; HRV infection was associated with 18% of cases of bronchiolitis and 47% of cases of URI. Among infants with HRV infection, 104 (64%) had HRV infection alone. Host factors associated with more severe HRV-associated illness included a maternal and family history of atopy (median score of 3.5 [interquartile range [IQR], 1.0-7.8] vs 2.0 [IQR, 1.0-5.2] and 3.5 [IQR, 1.0-7.5] vs 2.0 [IQR, 0-4.0]). In adjusted analyses maternal history of atopy conferred an increase in the risk for more severe HRV-associated bronchiolitis (odds ratio, 2.39; 95% CI, 1.14-4.99; P = .02). In a similar model maternal asthma was also associated with greater HRV-associated bronchiolitis severity (odds ratio, 2.49, 95% CI, 1.10-5.67; P = .03). Among patients with HRV infection, 35% had HRVA, 6% had HRVB, and 30% had HRVC.
CONCLUSION: HRV infection was a frequent cause of bronchiolitis and URIs among previously healthy term infants requiring hospitalization or unscheduled outpatient visits. Substantial viral genetic diversity was seen among the patients with HRV infection, and predominant groups varied by season and year. Host factors, including maternal atopy, were associated with more severe infant HRV-associated illness.
Authors:
E Kathryn Miller; John V Williams; Tebeb Gebretsadik; Kecia N Carroll; William D Dupont; Yassir A Mohamed; Laura-Lee Morin; Luke Heil; Patricia A Minton; Kimberly Woodward; Zhouwen Liu; Tina V Hartert
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-01-26
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  127     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-04     Completed Date:  2011-05-31     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  883-91     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Bronchiolitis / physiopathology,  virology
Common Cold / genetics,  physiopathology*,  virology*
Female
Humans
Hypersensitivity, Immediate / immunology
Infant
Male
Mothers
Reverse Transcriptase Polymerase Chain Reaction
Rhinovirus
Risk Factors
Grant Support
ID/Acronym/Agency:
K01 AI070808/AI/NIAID NIH HHS; K01 AI070808-03/AI/NIAID NIH HHS; K01 AI070808-04/AI/NIAID NIH HHS; K01 AI070808-05/AI/NIAID NIH HHS; K12 ES 015855/ES/NIEHS NIH HHS; K24 AI 077930/AI/NIAID NIH HHS; K24 AI077930/AI/NIAID NIH HHS; K24 AI077930-01/AI/NIAID NIH HHS; K24 AI077930-02/AI/NIAID NIH HHS; K24 AI077930-02S1/AI/NIAID NIH HHS; K24 AI077930-04/AI/NIAID NIH HHS; KL2 RR024977/RR/NCRR NIH HHS; KL2 RR024977-01/RR/NCRR NIH HHS; KL2 RR024977-02/RR/NCRR NIH HHS; KL2 RR024977-03/RR/NCRR NIH HHS; KL2 RR24977-03/RR/NCRR NIH HHS; KL2 TR000446/TR/NCATS NIH HHS; L40 HL086298-02A1/HL/NHLBI NIH HHS; R01 AI 05884/AI/NIAID NIH HHS; R01 HS018454/HS/AHRQ HHS; R01 HS019669/HS/AHRQ HHS; TL1 RR024978/RR/NCRR NIH HHS; TL1 TR000447/TR/NCATS NIH HHS; U01 HL 072471/HL/NHLBI NIH HHS; UL1 RR024975/RR/NCRR NIH HHS; UL1 RR024975/RR/NCRR NIH HHS; UL1 RR024975-02/RR/NCRR NIH HHS; UL1 RR024975-03/RR/NCRR NIH HHS; UL1 TR000445/TR/NCATS NIH HHS
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