Respiratory syncytial virus-associated illness in adults with advanced chronic obstructive pulmonary disease and/or congestive heart failure
Respiratory syncytial virus-associated illness in adults with advanced chronic obstructive pulmonary disease and/or congestive heart failure
复制标题
DOI：
10.1002/jmv.25285
复制
发表时间：
2019-01-01
影响因子：
12.7
通讯作者：
Griffin, M. Pam
中科院分区：
文献类型：
--
作者：
Falsey, Ann R.;Walsh, Edward E.;Griffin, M. Pam
背景方法呼吸道合胞病毒（RSV）是公认的慢性心肺疾病的严重病原体。对于经常和严重呼吸道合胞病毒感染的高危成人，可以考虑免疫预防。因此，我们研究了严重慢性阻塞性肺疾病（COPD）和/或充血性心力衰竭（CHF）成人中rsv相关的医学护理急性呼吸系统疾病（MARI）的发生率。受试者>= 50岁，患有黄金III/IV级COPD和/或美国心脏协会III/IV级CHF，并且每月接触儿童>=一次。研究对象在1.5至2.5年内评估rsv相关MARI，定义为聚合酶链反应（PCR）和/或血清反应。结论2011年10月至2012年5月共纳入445例受试者。总的来说，通过PCR或血清学记录了99例RSV感染，累计发病率为22.2%。其中，42例（9.4%）受试者有方案指定的RSV-MARI，发病率为4.68/100患者-季。全因MARI很常见（63.85/100患者-季），最常见的是鼻病毒。RSV感染在严重COPD和/或晚期CHF的成人中很常见。考虑到研究人群中潜在心肺疾病的严重程度，大多数疾病出奇地轻微。因此，主动免疫而不是单克隆抗体的被动免疫预防可能是一种更具成本效益的策略。
Background Methods Respiratory syncytial virus (RSV) is recognized as a serious pathogen in people with chronic cardiopulmonary conditions. Immunoprophylaxis might be considered for adults at high-risk for frequent and severe RSV infection. Thus, we studied the incidence of RSV-related medically attended acute respiratory illness (MARI) in adults with severe chronic obstructive pulmonary disease (COPD) and/or congestive heart failure (CHF). Subjects >= 50 years of age with Gold Class III/IV COPD and/or American Heart Association class III/IV CHF and exposure to children >= once per month were recruited. Subjects were evaluated over 1.5 to 2.5 years for RSV-associated MARI, defined as polymerase chain reaction (PCR) and/or seroresponse. Results Conclusion Four hundred forty-five subjects were enrolled between October 2011 and May 2012. Overall, 99 RSV infections were documented by PCR or serology for a cumulative incidence of 22.2%. Of these, 42 (9.4%) subjects had protocol-specified RSV-MARI for an incidence of 4.68/100 patient-seasons. All-cause MARI was common (63.85/100 patient-seasons) with rhinovirus most commonly identified. RSV infection was common in adults with severe COPD and/or advanced CHF. Given the severity of underlying cardiopulmonary diseases in the study population, most illnesses were surprisingly mild. Thus, active immunization rather than passive immunoprophylaxis with monoclonal antibodies may be a more cost-effective strategy.