• J. Clin. Virol. · Oct 2015

    Clinical and molecular epidemiology of human rhinovirus infections in patients with hematologic malignancy.

    • Samantha E Jacobs, Daryl M Lamson, Rosemary Soave, Brigitte Huertas Guzman, Tsiporah B Shore, Ellen K Ritchie, Dana Zappetti, Michael J Satlin, John P Leonard, Koen van Besien, Audrey N Schuetz, Stephen G Jenkins, George Kirsten St KS Virology Laboratory, Wadsworth Center, New York State Department of Health, Albany, New York, USA., and Thomas J Walsh.
    • Division of Infectious Diseases, Weill Cornell Medical Center, New York, NY, USA. Electronic address: sej9006@med.cornell.edu.
    • J. Clin. Virol. 2015 Oct 1; 71: 51-8.

    BackgroundHuman rhinoviruses (HRVs) are common causes of upper respiratory tract infection (URTI) in hematologic malignancy (HM) patients. Predictors of lower respiratory tract infection (LRTI) including the impact of HRV species and types are poorly understood.ObjectivesThis study aims to describe the clinical and molecular epidemiology of HRV infections among HM patients.Study DesignFrom April 2012-March 2013, HRV-positive respiratory specimens from symptomatic HM patients were molecularly characterized by analysis of partial viral protein 1 (VP1) or VP4 gene sequence. HRV LRTI risk-factors and outcomes were analyzed using multivariable logistic regression.ResultsOne hundred and ten HM patients presented with HRV URTI (n=78) and HRV LRTI (n=32). Hypoalbuminemia (OR 3.0; 95% CI, 1.0-9.2; p=0.05) was independently associated with LRTI, but other clinical and laboratory markers of host immunity did not differ between patients with URTI versus LRTI. Detection of bacterial co-pathogens was common in LRTI cases (25%). Among 92 typeable respiratory specimens, there were 58 (64%) HRV-As, 12 (13%) HRV-Bs, and 21 (23%) HRV-Cs, and one Enterovirus 68. LRTI rates among HRV-A (29%), HRV-B (17%), and HRV-C (29%) were similar. HRV-A infections occurred year-round while HRV-B and HRV-C infections clustered in the late fall and winter.ConclusionsHRVs are associated with LRTI in HM patients. Illness severity is not attributable to specific HRV species or types. The frequent detection of bacterial co-pathogens in HRV LRTIs further substantiates the hypothesis that HRVs predispose to bacterial superinfection of the lower airways, similar to that of other community-acquired respiratory viruses.Copyright © 2015 Elsevier B.V. All rights reserved.

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