Respiratory Virus Infection Among Hematopoietic Cell Transplant Recipients: Evidence for Asymptomatic Parainfluenza Virus Infection

Overview

Journal Blood

Publisher Elsevier

Specialty Hematology

Date 2007 May 16

PMID 17502457

Citations 110

Authors

Angela J Peck

Janet A Englund

Jane Kuypers

Katherine A Guthrie

Lawrence Corey

Rhoda Morrow

Robert C Hackman

Anne Cent

Michael Boeckh

Affiliations

Soon will be listed here.

Abstract

The incidence of respiratory virus infection after hematopoietic cell transplantation (HCT) has probably been underestimated with conventional testing methods in symptomatic patients. This prospective study assessed viral infection episodes by testing weekly respiratory samples collected from HCT recipients, with and without symptoms reported by questionnaire, for 100 days after HCT. Samples were tested by culture and direct fluorescent antibody testing for respiratory syncytial virus (RSV), parainfluenza virus (PIV), and influenza A and B, and by quantitative reverse transcription-polymerase chain reaction for RSV, PIV, influenza A and B, and metapneumovirus (MPV). Of 122 patients, 30 (25%) had 32 infection episodes caused by RSV (5), PIV (17), MPV (6), influenza (3), RSV, or influenza (1). PIV, with a cumulative incidence estimate of 17.9%, was the only virus for which asymptomatic infection was detected. Lower virus copy number in patients with no or one symptom compared with 2 or more symptoms was found for all viruses in all patients (P < .001), with PIV infection having a similar virus-specific comparison (P = .004). Subclinical infection with PIV may help explain why infection-control programs that emphasize symptoms are effective against RSV and influenza but often not against PIV.

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