Clinical and molecular epidemiology of human rhinovirus infections in patients with hematologic malignancy

Samantha E. Jacobs, Daryl M. Lamson, Rosemary Soave, Brigitte Huertas Guzman, Tsiporah B. Shore, Ellen K. Ritchie, Dana Zappetti, Michael J. Satlin, John P. Leonard, Koen van Besien, Audrey N. Schuetz, Stephen G. Jenkins, Kirsten St George, Thomas J. Walsh

Research output: Contribution to journalArticle

Abstract

Background: Human rhinoviruses (HRVs) are common causes of upper respiratory tract infection (URTI) in hematologic malignancy (HM) patients. Predictors of lower respiratory tract infection (LRTI) including the impact of HRV species and types are poorly understood. Objectives: This study aims to describe the clinical and molecular epidemiology of HRV infections among HM patients. Study design: From April 2012-March 2013, HRV-positive respiratory specimens from symptomatic HM patients were molecularly characterized by analysis of partial viral protein 1 (VP1) or VP4 gene sequence. HRV LRTI risk-factors and outcomes were analyzed using multivariable logistic regression. Results: One hundred and ten HM patients presented with HRV URTI (n= 78) and HRV LRTI (n= 32). Hypoalbuminemia (OR 3.0; 95% CI, 1.0-9.2; p= 0.05) was independently associated with LRTI, but other clinical and laboratory markers of host immunity did not differ between patients with URTI versus LRTI. Detection of bacterial co-pathogens was common in LRTI cases (25%). Among 92 typeable respiratory specimens, there were 58 (64%) HRV-As, 12 (13%) HRV-Bs, and 21 (23%) HRV-Cs, and one Enterovirus 68. LRTI rates among HRV-A (29%), HRV-B (17%), and HRV-C (29%) were similar. HRV-A infections occurred year-round while HRV-B and HRV-C infections clustered in the late fall and winter. Conclusions: HRVs are associated with LRTI in HM patients. Illness severity is not attributable to specific HRV species or types. The frequent detection of bacterial co-pathogens in HRV LRTIs further substantiates the hypothesis that HRVs predispose to bacterial superinfection of the lower airways, similar to that of other community-acquired respiratory viruses.

Original languageEnglish (US)
Article number3410
Pages (from-to)51-58
Number of pages8
JournalJournal of Clinical Virology
Volume71
DOIs
StatePublished - Oct 1 2015

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Keywords

  • Hematologic malignancy
  • Human rhinovirus
  • Immunocompromised hosts
  • Rhinovirus species
  • Viral pneumonia

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Jacobs, S. E., Lamson, D. M., Soave, R., Guzman, B. H., Shore, T. B., Ritchie, E. K., Zappetti, D., Satlin, M. J., Leonard, J. P., Besien, K. V., Schuetz, A. N., Jenkins, S. G., George, K. S., & Walsh, T. J. (2015). Clinical and molecular epidemiology of human rhinovirus infections in patients with hematologic malignancy. Journal of Clinical Virology, 71, 51-58. [3410]. https://doi.org/10.1016/j.jcv.2015.07.309