Epidemiology and persistence of rhinovirus in pediatric lung transplantation

Evan Ammerman; Stuart C. Sweet; Gregory A. Storch; Richard S. Buller; Sheila Mason; Carol Conrad; Don Hayes; Albert Faro; Samuel B. Goldfarb; Ernestina Melicoff; Marc Schecter; Gary Visner; Peter S. Heeger; Thalachallour Mohanakumar; Nikki Williams; Lara Danziger-Isakov

doi:10.1111/tid.13422

Epidemiology and persistence of rhinovirus in pediatric lung transplantation

Evan Ammerman, Stuart C. Sweet, Gregory A. Storch, Richard S. Buller, Sheila Mason, Carol Conrad, Don Hayes, Albert Faro, Samuel B. Goldfarb, Ernestina Melicoff, Marc Schecter, Gary Visner, Peter S. Heeger, Thalachallour Mohanakumar, Nikki Williams, Lara Danziger-Isakov

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4 Scopus citations

Abstract

Background: Infection with rhinovirus (HRV) occurs following pediatric lung transplantation. Prospective studies documenting frequencies, persistence, and progression of HRV in this at-risk population are lacking. Methods: In the Clinical Trials in Organ Transplant in Children prospective observational study, we followed 61 lung transplant recipients for 2 years. We quantified molecular subtypes of HRV in serially collected nasopharyngeal (NP) and bronchoalveolar lavage (BAL) samples and correlated them with clinical characteristics. Results: We identified 135 community-acquired respiratory infections (CARV) from 397 BAL and 480 NP samples. We detected 93 HRV events in 42 (68.8%) patients, 22 of which (23.4%) were symptomatic. HRV events were contiguous with different genotypes identified in 23 cases, but symptoms were not preferentially associated with any particular species. Nine (9.7%) HRV events persisted over multiple successive samples for a median of 36 days (range 18-408 days). Three persistent HRV were symptomatic. When we serially measured forced expiratory volume in one second (FEV1) in 23 subjects with events, we did not observe significant decreases in lung function over 12 months post-HRV. Conclusion: In conjunction with our previous reports, our prospectively collected data indicate that molecularly heterogeneous HRV infections occur commonly following pediatric lung transplantation, but these infections do not negatively impact clinical outcomes.

Original language	English (US)
Article number	e13422
Journal	Transplant Infectious Disease
Volume	22
Issue number	6
DOIs	https://doi.org/10.1111/tid.13422
State	Published - Dec 2020
Externally published	Yes

Bibliographical note

Funding Information:
This research was performed as a project of the Clinical Trials in Organ Transplantation in Children, a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases. The work was supported by Grant U01 AI077810 “Viral Triggers of Alloimmunity and Autoimmunity in Pediatric Lung Transplantation” from the Division of Allergy, Immunology and Transplantation of the National Institutes of Health. 33

Funding Information:
This research was performed as a project of the Clinical Trials in Organ Transplantation in Children, a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases. The work was supported by Grant U01 AI077810 ?Viral Triggers of Alloimmunity and Autoimmunity in Pediatric Lung Transplantation? from the Division of Allergy, Immunology and Transplantation of the National Institutes of Health.33

Publisher Copyright:
© 2020 Wiley Periodicals LLC

Keywords

community-acquired respiratory virus (CARV)
forced expiratory volume (FEV1)
human rhinovirus (HRV)
lung transplantation
pediatrics

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Ammerman, E., Sweet, S. C., Storch, G. A., Buller, R. S., Mason, S., Conrad, C., Hayes, D., Faro, A., Goldfarb, S. B., Melicoff, E., Schecter, M., Visner, G., Heeger, P. S., Mohanakumar, T., Williams, N., & Danziger-Isakov, L. (2020). Epidemiology and persistence of rhinovirus in pediatric lung transplantation. Transplant Infectious Disease, 22(6), Article e13422. https://doi.org/10.1111/tid.13422

Ammerman, E, Sweet, SC, Storch, GA, Buller, RS, Mason, S, Conrad, C, Hayes, D, Faro, A, Goldfarb, SB, Melicoff, E, Schecter, M, Visner, G, Heeger, PS, Mohanakumar, T, Williams, N & Danziger-Isakov, L 2020, 'Epidemiology and persistence of rhinovirus in pediatric lung transplantation', Transplant Infectious Disease, vol. 22, no. 6, e13422. https://doi.org/10.1111/tid.13422

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title = "Epidemiology and persistence of rhinovirus in pediatric lung transplantation",

abstract = "Background: Infection with rhinovirus (HRV) occurs following pediatric lung transplantation. Prospective studies documenting frequencies, persistence, and progression of HRV in this at-risk population are lacking. Methods: In the Clinical Trials in Organ Transplant in Children prospective observational study, we followed 61 lung transplant recipients for 2 years. We quantified molecular subtypes of HRV in serially collected nasopharyngeal (NP) and bronchoalveolar lavage (BAL) samples and correlated them with clinical characteristics. Results: We identified 135 community-acquired respiratory infections (CARV) from 397 BAL and 480 NP samples. We detected 93 HRV events in 42 (68.8%) patients, 22 of which (23.4%) were symptomatic. HRV events were contiguous with different genotypes identified in 23 cases, but symptoms were not preferentially associated with any particular species. Nine (9.7%) HRV events persisted over multiple successive samples for a median of 36 days (range 18-408 days). Three persistent HRV were symptomatic. When we serially measured forced expiratory volume in one second (FEV1) in 23 subjects with events, we did not observe significant decreases in lung function over 12 months post-HRV. Conclusion: In conjunction with our previous reports, our prospectively collected data indicate that molecularly heterogeneous HRV infections occur commonly following pediatric lung transplantation, but these infections do not negatively impact clinical outcomes.",

keywords = "community-acquired respiratory virus (CARV), forced expiratory volume (FEV1), human rhinovirus (HRV), lung transplantation, pediatrics",

author = "Evan Ammerman and Sweet, {Stuart C.} and Storch, {Gregory A.} and Buller, {Richard S.} and Sheila Mason and Carol Conrad and Don Hayes and Albert Faro and Goldfarb, {Samuel B.} and Ernestina Melicoff and Marc Schecter and Gary Visner and Heeger, {Peter S.} and Thalachallour Mohanakumar and Nikki Williams and Lara Danziger-Isakov",

note = "Funding Information: This research was performed as a project of the Clinical Trials in Organ Transplantation in Children, a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases. The work was supported by Grant U01 AI077810 “Viral Triggers of Alloimmunity and Autoimmunity in Pediatric Lung Transplantation” from the Division of Allergy, Immunology and Transplantation of the National Institutes of Health. 33 Funding Information: This research was performed as a project of the Clinical Trials in Organ Transplantation in Children, a collaborative clinical research project headquartered at the National Institute of Allergy and Infectious Diseases. The work was supported by Grant U01 AI077810 ?Viral Triggers of Alloimmunity and Autoimmunity in Pediatric Lung Transplantation? from the Division of Allergy, Immunology and Transplantation of the National Institutes of Health.33 Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC",

year = "2020",

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AU - Ammerman, Evan

AU - Sweet, Stuart C.

AU - Storch, Gregory A.

AU - Buller, Richard S.

AU - Mason, Sheila

AU - Conrad, Carol

AU - Hayes, Don

AU - Faro, Albert

AU - Goldfarb, Samuel B.

AU - Melicoff, Ernestina

AU - Schecter, Marc

AU - Visner, Gary

AU - Heeger, Peter S.

AU - Mohanakumar, Thalachallour

AU - Williams, Nikki

AU - Danziger-Isakov, Lara

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PY - 2020/12

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N2 - Background: Infection with rhinovirus (HRV) occurs following pediatric lung transplantation. Prospective studies documenting frequencies, persistence, and progression of HRV in this at-risk population are lacking. Methods: In the Clinical Trials in Organ Transplant in Children prospective observational study, we followed 61 lung transplant recipients for 2 years. We quantified molecular subtypes of HRV in serially collected nasopharyngeal (NP) and bronchoalveolar lavage (BAL) samples and correlated them with clinical characteristics. Results: We identified 135 community-acquired respiratory infections (CARV) from 397 BAL and 480 NP samples. We detected 93 HRV events in 42 (68.8%) patients, 22 of which (23.4%) were symptomatic. HRV events were contiguous with different genotypes identified in 23 cases, but symptoms were not preferentially associated with any particular species. Nine (9.7%) HRV events persisted over multiple successive samples for a median of 36 days (range 18-408 days). Three persistent HRV were symptomatic. When we serially measured forced expiratory volume in one second (FEV1) in 23 subjects with events, we did not observe significant decreases in lung function over 12 months post-HRV. Conclusion: In conjunction with our previous reports, our prospectively collected data indicate that molecularly heterogeneous HRV infections occur commonly following pediatric lung transplantation, but these infections do not negatively impact clinical outcomes.

AB - Background: Infection with rhinovirus (HRV) occurs following pediatric lung transplantation. Prospective studies documenting frequencies, persistence, and progression of HRV in this at-risk population are lacking. Methods: In the Clinical Trials in Organ Transplant in Children prospective observational study, we followed 61 lung transplant recipients for 2 years. We quantified molecular subtypes of HRV in serially collected nasopharyngeal (NP) and bronchoalveolar lavage (BAL) samples and correlated them with clinical characteristics. Results: We identified 135 community-acquired respiratory infections (CARV) from 397 BAL and 480 NP samples. We detected 93 HRV events in 42 (68.8%) patients, 22 of which (23.4%) were symptomatic. HRV events were contiguous with different genotypes identified in 23 cases, but symptoms were not preferentially associated with any particular species. Nine (9.7%) HRV events persisted over multiple successive samples for a median of 36 days (range 18-408 days). Three persistent HRV were symptomatic. When we serially measured forced expiratory volume in one second (FEV1) in 23 subjects with events, we did not observe significant decreases in lung function over 12 months post-HRV. Conclusion: In conjunction with our previous reports, our prospectively collected data indicate that molecularly heterogeneous HRV infections occur commonly following pediatric lung transplantation, but these infections do not negatively impact clinical outcomes.

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Epidemiology and persistence of rhinovirus in pediatric lung transplantation

Abstract

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