Recurrent and persistent respiratory tract viral infections in patients with primary hypogammaglobulinemia

被引:91
作者
Kainulainen, Leena [1 ,2 ]
Vuorinen, Tytti [4 ]
Rantakokko-Jalava, Kaisu [3 ]
Osterback, Riikka [4 ]
Ruuskanen, Olli [1 ]
机构
[1] Turku Univ Hosp, Dept Pediat, Turku 20521, Finland
[2] Turku Univ Hosp, Dept Internal Med, Turku 20521, Finland
[3] Turku Univ Hosp, Dept Med Microbiol, Turku 20521, Finland
[4] Turku Univ, Dept Virol, Turku, Finland
关键词
Primary immunodeficiency; hypogammaglobulinemia; X-linked agammaglobulinemia; common variable immunodeficiency; rhinovirus; respiratory virus; respiratory tract infection; immunoglobulin replacement therapy; COMMUNITY-ACQUIRED PNEUMONIA; X-LINKED AGAMMAGLOBULINEMIA; PARALYTIC POLIOMYELITIS; RHINOVIRUS; CHILDREN; IMMUNODEFICIENCY; ASSOCIATION; BACTERIA; VIRUSES; AIRWAYS;
D O I
10.1016/j.jaci.2010.04.016
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: The occurrence of respiratory tract viral infections in patients with primary hypogammaglobulinemia has not been studied. Objective: We conducted a prospective 12-month follow-up study of respiratory tract infections in 12 adult patients with primary hypogammaglobulinemia. Methods: Nasal swab samples and induced sputum samples were taken at the onset of acute respiratory tract infection and every 3 months thereafter. Samples were tested for bacteria and viruses. PCR tests were performed for 15 respiratory tract viruses. In case the results for rhinovirus were positive, follow-up nasal swab samples were taken every 2 weeks until rhinoviral PCR results became negative. Patients completed symptom diaries, which were collected every month. The spouses of the patients served as healthy control subjects. Results: During the 12-month period, the 12 patients had 65 episodes of acute respiratory tract infections, and the 11 spouses had 12 acute episodes (P<.001). Respiratory tract viruses were found in sputum in 54% of the infections. Rhinovirus was the most common virus. In more than half of our patients, rhinoviral PCR results stayed positive for more than 2 months. The most long-acting persistence with the same rhinovirus was 4 months. Conclusions: Despite adequate immunoglobulin replacement therapy, patients with primary hypogammaglobulinemia have increased susceptibility to respiratory tract viral infections. Rhinoviral infections are frequent and prolonged. (J Allergy Clin Immunol 2010;126:120-6.)
引用
收藏
页码:120 / 126
页数:7
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