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. 2011;6(11):e27247.
doi: 10.1371/journal.pone.0027247. Epub 2011 Nov 8.

Detection of Human Rhinovirus C Viral Genome in Blood Among Children With Severe Respiratory Infections in the Philippines

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Free PMC article

Detection of Human Rhinovirus C Viral Genome in Blood Among Children With Severe Respiratory Infections in the Philippines

Naoko Fuji et al. PLoS One. .
Free PMC article

Abstract

Human rhinovirus (HRV) C was recently identified as the third species of HRV using a molecular technique. Infections caused by previously identified HRVs (A and B) are thought to be limited to the respiratory tract; however, pathogenesis of HRVC is still largely unknown. A total of 816 nasopharyngeal swabs from hospitalized children with severe respiratory infections in the Philippines (May 2008-May 2009) were tested for HRV by reverse transcription polymerase chain reaction (RT-PCR), and 243 samples (29.8%) were positive for HRV. Among these patients, serum samples were also tested to determine whether specific HRV species were associated with viremia. Only 30 serum samples (12.3%) were positive for HRV. However, the HRV positive rates were different among HRV species, 3% (4/135) for HRVA, 0% (0/25) for HRVB, and 31% (26/83) for HRVC, and were the highest on 2 days after the onset of symptoms. These results suggest that HRVC may have a different pathogenicity and can more commonly cause viremia than HRVA and HRVB. Serum positive rates for HRV are affected by age, i.e., higher positive rates for those aged 1 year or more. HRVC that were detected from serum exhibited the same level of sequence diversity as those positive only for nasopharyngeal samples in phylogenetic analysis. However, all HRVA which were detected from serum were clustered in a monophyletic clade based on their 5' non-coding region (NCR) sequences, which is closely related with a certain HRVC genotype (A2) in 5'-NCR. This finding suggests that the 5'NCR region may be associated with viremia.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Phylogenetic tree of 5′NCR.
Black open circle indicates the HRVs detected only from nasopharyngeal swab samples. Filled red circle and triangle indicate S-1 and S-2 serum positives, respectively. Blue: HRVA, Yellow: HRVB, and Red: HRVC. Red branch indicates specific clade that is shared between HRVA and HRVC (A2). Phylogeny was inferred using NJ method on MEGA 4.1.
Figure 2
Figure 2. Phylogenetic tree of VP4-VP2.
Black open circle indicates the HRVs detected only from nasopharyngeal swab samples. Red circle indicates the HRVs detected from both nasopharyngeal swab and serum samples. Phylogeny was inferred using NJ method on MEGA 4.1.
Figure 3
Figure 3. HRV RNA detection in serum by RT-PCR based on number of days after onset.
S-1 and S-2 indicate serum samples that were collected upon admission (S-1) and 3 days after admission (S-2). Date shown is the sampling date measured from onset of symptoms. Only PCR samples positive on S-1 were proceeded for the next analysis on S-2. The positivity rate was calculated with total (S-1+S-2) positive and negative numbers.
Figure 4
Figure 4. SpO2 by age groups with and without HRV RNA in serum.
S+ and S− indicate RNA serum positivity and serum negativity, respectively. Bar indicates the range between maximum and minimum values. Thick bar indicates interquartile range. Median and outliers are shown as a lateral bar and asterisk, respectively. p<0.05, † †p<0.01.

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