Low incidence of severe respiratory syncytial virus infections in lung transplant recipients despite the absence of specific therapy.

Details

Serval ID
serval:BIB_F4DDBA4898BF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Low incidence of severe respiratory syncytial virus infections in lung transplant recipients despite the absence of specific therapy.
Journal
The Journal of heart and lung transplantation
Author(s)
Uçkay I., Gasche-Soccal P.M., Kaiser L., Stern R., Mazza-Stalder J., Aubert J.D., van Delden C.
ISSN
1557-3117 (Electronic)
ISSN-L
1053-2498
Publication state
Published
Issued date
03/2010
Peer-reviewed
Oui
Volume
29
Number
3
Pages
299-305
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Respiratory syncytial virus (RSV) infections in lung transplant recipients (LTRs) have been associated with significant morbidity and mortality. Immunoglobulins, ribavirin, and palivizumab are suggested treatments for both pre-emptive and therapeutic purposes. However, in the absence of randomized, placebo-controlled trials, efficacy is controversial and there is toxicity as well as cost concerns.
We retrospectively reviewed cases of lower respiratory tract RSV infections in adult LTRs. Diagnosis was based on clinical history, combined with a positive polymerase chain reaction (PCR) and/or viral cultures of bronchoalveolar lavage (BAL) specimens.
Ten symptomatic patients were identified (7 men and 3 women, age range 28 to 64 years). All were hospitalized for community-acquired respiratory tract infections. Two patients had a concomitant acute Grade A3 graft rejection, and 1 patient had a concomitant bacterial pneumonia. Eight patients did not receive a specific anti-RSV treatment because of clinical stability and/or improvement at the time of RSV diagnosis. Only 2 patients (1 with Grade A3 allograft rejection and 1 requiring mechanical ventilation) received ribavirin and palivizumab. All patients recovered without complications and with no persistent RSV infection. However, bronchiolitis obliterans (BOS) staging worsened in 6 patients during the mean follow-up of 45 months.
Our data suggest that mild RSV infections in LTRs might evolve favorably in the absence of specific anti-viral therapy. However, this observation needs confirmation in a large clinical trial specifically investigating the development of BOS in untreated vs treated patients.
Keywords
Adult, Antiviral Agents/therapeutic use, Bronchoalveolar Lavage Fluid/virology, Female, Forced Expiratory Volume/physiology, Humans, Incidence, Lung/virology, Lung Diseases/surgery, Lung Transplantation, Male, Middle Aged, Postoperative Complications/drug therapy, Postoperative Complications/epidemiology, Postoperative Complications/virology, Respiratory Syncytial Virus Infections/drug therapy, Respiratory Syncytial Virus Infections/epidemiology, Respiratory Syncytial Virus Infections/physiopathology, Respiratory Syncytial Viruses/isolation & purification, Retrospective Studies, Severity of Illness Index
Pubmed
Web of science
Create date
21/10/2009 14:40
Last modification date
21/01/2021 7:25
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