Oral versus inhaled ribavirin therapy for respiratory syncytial virus infection after lung transplantation

Lily Li, Robin Avery, Marie Budev, Sherif Mossad, Lara Danziger-Isakov

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Respiratory syncytial virus (RSV) is a significant contributor to morbidity in adult lung transplant recipients. Multiple modes of ribavirin administration have been described in the literature. This study investigated outcomes related to delivery route. Methods: We performed a retrospective analysis of adult lung transplant patients infected with RSV (2006-2010). RSV severity was graded according to clinical symptoms and bronchiolitis obliterans syndrome (BOS) status on International Society for Heart and Lung Transplantation (ISHLT) criteria. Relationships between route of ribavirin delivery and RSV severity, BOS progression at 6 months after RSV infection, and overall survival were assessed. Of 30 RSV-positive patients identified, 9 were ultimately excluded. Results: The 21 study patients were a mean age of 49 ± 17 years (range, 17-72 years) at transplant. Six received oral and 15 received inhaled ribavirin per clinician preference. No significant differences were observed between the groups by age, sex, or ethnicity. Mean time from transplant to RSV was 26 ± 29 months (range, 1-100 months). Infections were mild in 2 of 6 patients in the oral compared with 11 of 15 in the inhaled group (p = 0.17). None of the oral group and 3 of the inhaled group exhibited BOS 1 at time of infection (p = 0.53); 2 (inhaled) had new onset/progression of BOS at 6 months after RSV (p > 0.99). No difference in overall survival (p = 0.41) was observed between the 2 groups. Conclusions: This retrospective study demonstrates no significant differences in 6-month outcomes between oral and inhaled ribavirin therapy for RSV infection after lung transplantation.

Original languageEnglish (US)
Pages (from-to)839-844
Number of pages6
JournalJournal of Heart and Lung Transplantation
Volume31
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

Keywords

  • BOS progression
  • inhaled ribavirin
  • lung transplantation
  • oral ribavirin
  • respiratory syncytial virus

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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