RESPIRATORY SYNCYTIAL VIRAL-INFECTION IN CHILDREN WITH COMPROMISED IMMUNE FUNCTION
RESPIRATORY SYNCYTIAL VIRAL-INFECTION IN CHILDREN WITH COMPROMISED IMMUNE FUNCTION
复制标题
DOI：
10.1056/nejm198607103150201
复制
发表时间：
1986-07-10
影响因子：
158.5
通讯作者：
COHEN, HJ
中科院分区：
文献类型：
--
作者：
HALL, CB;POWELL, KR;COHEN, HJ
连续 10 个冬天，对 608 名因呼吸道合胞病毒（RSV）感染住院的 5 岁或以下儿童进行了前瞻性研究，以评估他们的免疫状态与感染严重程度之间的关系。 47 人因化疗、类固醇治疗或原发性免疫缺陷病而导致免疫功能低下。在免疫功能低下的儿童中，接受癌症化疗的儿童和患有免疫缺陷疾病的儿童RSV疾病更为严重，肺炎发生在所有年龄段，死亡率也更高。接受长期类固醇治疗的儿童似乎没有比正常儿童更严重的临床表现。然而，在接受类固醇治疗的儿童中，尤其是在接受化疗或患有免疫缺陷疾病的儿童中，病毒排出量明显更大且持续时间更长。据报道，一名患有白血病的儿童患有巨细胞肺炎。超过一半的免疫功能低下儿童是在医院感染 RSV 的。这些发现表明，接受癌症化疗的儿童和患有免疫缺陷疾病的儿童有发生 RSV 复杂或致命感染的风险，应考虑接受抗病毒和其他治疗。如果无法避免住院，还应努力保护受影响的儿童。
For 10 winters, 608 children five years old or younger who were hospitalized with respiratory syncytial virus (RSV) infection were prospectively studied to evaluate the relation between their immune status and the severity of their infection. Forty-seven had veen immunocompromised by chemotherapy, steroid therapy, or a primary immunodeficiency disorder. Among the immunocompromised children, those receiving, chemotherapy for cancer and those with immunodeficiency disease had more severe RSV disease, with pneumonia occurring at all ages, and a higher mortality rate. Children receiving long-term steroid therapy did not appear to have more severe clinical manifestations than normal children. Viral shedding, however, was significantly greater and more prolonged in the children receiving steroid therapy, and particularly in those receiving chemotherapy or with an immunodeficiency disease. Giant-cell pneumonia was documented in one child with leukemia. Over half the immunocompromised children acquired the RSV infection nosocomially. These findings indicate that children receiving chemotherapy for cancer and those with immunodeficiency disease are risk for complicated or fatal infections from RSV and should be considered for antiviral and other therapies as they become available. Efforts shold also be made to protect compromised children if hospitalization cannot be avoided.