Status: Funded - Closed
Molecular epidemiology of rhinovirus detections in children in the Peruvian Andes
Leigh Howard, M.D., MPH
BACKGROUND: Human rhinoviruses (HRVs) are frequently detected in children with acute respiratory illnesses (ARIs); however, they are also frequently detected in asymptomatic children, complicating their clinical interpretation. Whether repeated HRV detections during symptomatic and asymptomatic periods represent different HRV infections or persistent nasopharyngeal carriage of the same HRV remains unclear.
GAP: Most previous studies that evaluated the pathogenic roles of HRV genotypes are limited in that HRV detections were compared between children with ARI and other children without ARI. Our study, during which samples were longitudinally collected during ARIs and asymptomatic episodes in individual children, sought to clarify the pathogenic role of specific HRV genotypes in respiratory diseases in young children.
HYPOTHESIS: We hypothesized that infections with distinctive HRV genotypes would result in different spectrums of clinical disease and that most repeated HRV detections in individuals would represent new infections by distinctive HRV genotypes rather than persistent carriage of a single genotype.
METHODS: This study utilized data from the prospective RESPIRA PERU cohort study, during which clinical data and respiratory samples were regularly collected from children under three through active weekly household-based surveillance visits. HRVs detected in children during asymptomatic and ARI periods were genotyped to compare the clinical features of ARIs associated with distinct HRV genotypes and to determine the genetic diversity of repeated HRV detections over time within individuals.
RESULTS: Among 207 ARI samples sequenced, HRV-A-, HRV-B, and HRV-C were detected in 104 (50%), 20 (10%), and 83 (40%), respectively. Presence of fever, decreased appetite, and malaise were significantly higher in children with HRV-B. When codetections with other viruses were excluded (n=155), these trends persisted, but some did not reach statistical significance. When 58 paired sequential HRV detections during asymptomatic and ARI episodes were sequenced, only 9 (16%) were identical genotypes of HRV.
IMPACT: The association between HRV detection and clinical disease in children and the differences in pathogenicity according to HRV genotype are complex. In our study, the clinical features of HRV infection differed among species. Repeated detections in young children frequently represented acquisition of new HRV strains
Vanderbilt University Medical Center
Tennessee, San Marcos