Concurrent detection of other respiratory viruses in children shedding viable human respiratory syncytial virus

J Med Virol. 2013 Oct;85(10):1852-9. doi: 10.1002/jmv.23648. Epub 2013 Jul 16.

Abstract

Human respiratory syncytial virus (HRSV) is an important cause of respiratory disease. The majority of studies addressing the importance of virus co-infections to the HRSV-disease have been based on the detection of HRSV by RT-PCR, which may not distinguish current replication from prolonged shedding of remnant RNA from previous HRSV infections. To assess whether co-detections of other common respiratory viruses are associated with increased severity of HRSV illnesses from patients who were shedding viable-HRSV, nasopharyngeal aspirates from children younger than 5 years who sought medical care for respiratory infections in Ribeirão Preto (Brazil) were tested for HRSV by immunofluorescence, RT-PCR and virus isolation in cell culture. All samples with viable-HRSV were tested further by PCR for other respiratory viruses. HRSV-disease severity was assessed by a clinical score scale. A total of 266 samples from 247 children were collected and 111 (42%) were HRSV-positive. HRSV was isolated from 70 (63%), and 52 (74%) of them were positive for at least one additional virus. HRSV-positive diseases were more severe than HRSV-negative ones, but there was no difference in disease severity between patients with viable-HRSV and those HRSV-positives by RT-PCR. Co-detection of other viruses did not correlate with increased disease severity. HRSV isolation in cell culture does not seem to be superior to RT-PCR to distinguish infections associated with HRSV replication in studies of clinical impact of HRSV. A high rate of co-detection of other respiratory viruses was found in samples with viable-HRSV, but this was not associated with more severe HRSV infection.

Keywords: HRSV infection; HRSV isolation; respiratory virus co-infection; severity of HRSV disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • Child, Preschool
  • Coinfection / pathology
  • Coinfection / virology*
  • Female
  • Fluorescent Antibody Technique
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nasopharynx / virology
  • RNA Viruses / isolation & purification*
  • Respiratory Tract Infections / pathology
  • Respiratory Tract Infections / virology*
  • Reverse Transcriptase Polymerase Chain Reaction
  • Severity of Illness Index
  • Virus Cultivation
  • Virus Diseases / pathology
  • Virus Diseases / virology*