Human Metapneumovirus in High Risk Populations

描述（由申请人提供）：2001年6月，研究人员报告了一种新发现的人类副粘病毒的令人兴奋的发现，这种病毒可能解释急性呼吸道疾病的重要部分。关于这种人偏肺病毒（HMPV）的流行病学所知相对较少。少数已发表的研究只涉及美国以外的患者。现有数据表明，HMPV可能导致多达15%的急性呼吸道疾病，可能导致严重呼吸道疾病和死亡，HMPV至少有两种主要基因型，并且感染所有年龄组。关于人乳头状病毒感染仍有许多问题。特定人群（如老年人或免疫功能低下者）是否有更高的感染风险？农村人口感染HMPV的风险较大。特定HMPV基因型是否更常与严重疾病相关？HMPV疾病是否存在显著的时间、地理或遗传变异？我们计划开展一系列人偏肺病毒的流行病学研究，以降低人偏肺病毒的发病率为长期目标。这个应用程序是我们实现这个目标的第一步。在这项研究中，我们将确定HMPV感染高发的中西部人群，并确定美国中西部的HMPV分离株是否与美国以外收集的HMPV分离株存在基因典型差异。我们将通过使用RT-PCR对2000年至2004年在中西部地区医疗中心门诊和住院急性呼吸道感染患者收集的1500个病毒培养标本进行评估来实现这一目标。通过单因素和多因素技术，将在1500名研究患者中确定HMPV RT-PCR阳性的人口统计学和临床危险因素。将培养RT-PCR阳性的标本，并将HMPV分离株与先前鉴定的HMPV分离株进行遗传变异的系统发育比较。这些数据将有助于开展更全面的流行病学研究，并指导未来减少HMPV发病率的干预研究。

DESCRIPTION (provided by applicant): In June 2001, investigators reported the exciting discovery of a newly recognized human paramyxovirus that may explain a significant portion of acute respiratory illnesses. Relatively little is known regarding the epidemiology of this human metapneumovirus (HMPV). The few published studies have exclusively involved patients from outside of the United States. Available data suggest that HMPV may cause as much as 15% of acute respiratory illness, may cause serious respiratory illness and death, that HMPV has at least two major genotypes, and that it infects all age-groups. There remain many questions regarding HMPV infections. Are specific populations, such as the elderly or the immunocompromised, at increased risk of infection? Are rural populations are greater risk of HMPV infection. Are specific HMPV genotypes more often associated with severe disease? Are there significant temporal, geographical, or genetic variations in HMPV disease? We plan to initiate a series of epidemiological studies of human metapneumovirus with a long term goal of reducing HMPV morbidity. This application is our first step towards that goal. In it we will identify Midwestern populations with a high prevalence of HMPV infection and determine if US Midwestern HMPV isolates genotypically differ from those collected outside of the United States. We will accomplish this by using RT-PCR to evaluate1500 viral culture specimens collected during the years 2000 to 2004 from outpatients and inpatients suffering from acute respiratory infection at a Midwestern regional medical center. Through univariate and multivariate techniques, demographic and clinical risk factors for HMPV RT-PCR positivity will be identified among the 1500 patients studied. Specimens that are RT-PCR positive will be cultured and HMPV isolates will be phylogenetically compared with previously identified HMPV isolates for genetic variation. These data will facilitate the development of more comprehensive epidemiological studies, and guide future intervention studies in reducing HMPV morbidity.