Cargando…
871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation
BACKGROUND: Invasive aspergillosis (IA) is a serious infectious complication following hematopoietic cell transplantation (HCT). Few studies have reported respiratory viral infections (RVIs) as a risk factor for developing IA, and data regarding specific viruses is sparse. We examined whether specif...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252578/ http://dx.doi.org/10.1093/ofid/ofy209.055 |
_version_ | 1783373295106654208 |
---|---|
author | Ogimi, Chikara Campbell, Angela P Xie, Hu Fisher, Cynthia Kuypers, Jane Jerome, Keith Chien, Jason Callais, Cheryl Waghmare, Alpana Cheng, Guang-Shing Leisenring, Wendy Englund, Janet Boeckh, Michael |
author_facet | Ogimi, Chikara Campbell, Angela P Xie, Hu Fisher, Cynthia Kuypers, Jane Jerome, Keith Chien, Jason Callais, Cheryl Waghmare, Alpana Cheng, Guang-Shing Leisenring, Wendy Englund, Janet Boeckh, Michael |
author_sort | Ogimi, Chikara |
collection | PubMed |
description | BACKGROUND: Invasive aspergillosis (IA) is a serious infectious complication following hematopoietic cell transplantation (HCT). Few studies have reported respiratory viral infections (RVIs) as a risk factor for developing IA, and data regarding specific viruses is sparse. We examined whether specific respiratory viruses were associated with increased risk of developing IA post-HCT. METHODS: In a longitudinal surveillance study of RVIs among allogeneic HCT recipients conducted 2005–2010, weekly post-HCT nasal washes were collected through day 100, then every 3 months, and whenever respiratory symptoms occurred through 1 year post-HCT. Nasal and bronchoalveolar lavage (BAL) samples were tested by multiplex PCR for respiratory syncytial virus (RSV), parainfluenza viruses (PIV)1–4, influenza A/B, human metapneumovirus, adenovirus (ADV), and human rhinoviruses, and coronaviruses. Only respiratory virus detections with symptoms were counted as RVI. Separate Cox proportional hazards models were used to examine adjusted associations between each RVI and the development of first proven/probable IA by 1-year post-HCT. RESULTS: Among 437 patients who survived >28 days following HCT, 39 patients developed IA by 1-year post-HCT (median 87 days, range 5–283). After adjusting for age at HCT, neutropenia, high-grade CMV viremia, and HLA status (matched related vs. others) or severe acute graft-versus-host disease (GVHD Grade 0–2 vs. 3–4), RSV and ADV upper respiratory tract infections (URTI) were associated with increased risk of developing IA (figure). Detection of any respiratory virus in the BAL was associated with IA (P < 0.001). CONCLUSION: RSV and ADV URTI are significant risk factors for development of IA post-HCT; the association between PIV URTI and development of IA approached statistical significance. Viral lower respiratory tract infection was associated with IA. Our data provide a rationale to assess IA as an endpoint in preventive studies of novel agents for respiratory viruses and further emphasize the importance of effective infection prevention practices for RVIs after HCT. [Image: see text] DISCLOSURES: J. Chien, Gilead Sciences, Inc.: Employee and Shareholder, Salary and stocks. A. Waghmare, Ablynx: Investigator, Research support. J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. M. Boeckh, Asun Biopharma: Consultant and Investigator, Consulting fee and Research support. Gilead Sciences: Consultant and Investigator, Consulting fee and Research support. Chimerix Inc.: Consultant and Investigator, Consulting fee and Research support. Humabs: Consultant, Consulting fee. GSK: Investigator, Research support. |
format | Online Article Text |
id | pubmed-6252578 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62525782018-11-28 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation Ogimi, Chikara Campbell, Angela P Xie, Hu Fisher, Cynthia Kuypers, Jane Jerome, Keith Chien, Jason Callais, Cheryl Waghmare, Alpana Cheng, Guang-Shing Leisenring, Wendy Englund, Janet Boeckh, Michael Open Forum Infect Dis Abstracts BACKGROUND: Invasive aspergillosis (IA) is a serious infectious complication following hematopoietic cell transplantation (HCT). Few studies have reported respiratory viral infections (RVIs) as a risk factor for developing IA, and data regarding specific viruses is sparse. We examined whether specific respiratory viruses were associated with increased risk of developing IA post-HCT. METHODS: In a longitudinal surveillance study of RVIs among allogeneic HCT recipients conducted 2005–2010, weekly post-HCT nasal washes were collected through day 100, then every 3 months, and whenever respiratory symptoms occurred through 1 year post-HCT. Nasal and bronchoalveolar lavage (BAL) samples were tested by multiplex PCR for respiratory syncytial virus (RSV), parainfluenza viruses (PIV)1–4, influenza A/B, human metapneumovirus, adenovirus (ADV), and human rhinoviruses, and coronaviruses. Only respiratory virus detections with symptoms were counted as RVI. Separate Cox proportional hazards models were used to examine adjusted associations between each RVI and the development of first proven/probable IA by 1-year post-HCT. RESULTS: Among 437 patients who survived >28 days following HCT, 39 patients developed IA by 1-year post-HCT (median 87 days, range 5–283). After adjusting for age at HCT, neutropenia, high-grade CMV viremia, and HLA status (matched related vs. others) or severe acute graft-versus-host disease (GVHD Grade 0–2 vs. 3–4), RSV and ADV upper respiratory tract infections (URTI) were associated with increased risk of developing IA (figure). Detection of any respiratory virus in the BAL was associated with IA (P < 0.001). CONCLUSION: RSV and ADV URTI are significant risk factors for development of IA post-HCT; the association between PIV URTI and development of IA approached statistical significance. Viral lower respiratory tract infection was associated with IA. Our data provide a rationale to assess IA as an endpoint in preventive studies of novel agents for respiratory viruses and further emphasize the importance of effective infection prevention practices for RVIs after HCT. [Image: see text] DISCLOSURES: J. Chien, Gilead Sciences, Inc.: Employee and Shareholder, Salary and stocks. A. Waghmare, Ablynx: Investigator, Research support. J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. M. Boeckh, Asun Biopharma: Consultant and Investigator, Consulting fee and Research support. Gilead Sciences: Consultant and Investigator, Consulting fee and Research support. Chimerix Inc.: Consultant and Investigator, Consulting fee and Research support. Humabs: Consultant, Consulting fee. GSK: Investigator, Research support. Oxford University Press 2018-11-26 /pmc/articles/PMC6252578/ http://dx.doi.org/10.1093/ofid/ofy209.055 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Ogimi, Chikara Campbell, Angela P Xie, Hu Fisher, Cynthia Kuypers, Jane Jerome, Keith Chien, Jason Callais, Cheryl Waghmare, Alpana Cheng, Guang-Shing Leisenring, Wendy Englund, Janet Boeckh, Michael 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation |
title | 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation |
title_full | 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation |
title_fullStr | 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation |
title_full_unstemmed | 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation |
title_short | 871. Symptomatic Respiratory Syncytial Virus and Adenovirus Upper Respiratory Tract Infections Increase the Risk of Invasive Aspergillosis After Allogeneic Hematopoietic Cell Transplantation |
title_sort | 871. symptomatic respiratory syncytial virus and adenovirus upper respiratory tract infections increase the risk of invasive aspergillosis after allogeneic hematopoietic cell transplantation |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252578/ http://dx.doi.org/10.1093/ofid/ofy209.055 |
work_keys_str_mv | AT ogimichikara 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT campbellangelap 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT xiehu 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT fishercynthia 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT kuypersjane 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT jeromekeith 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT chienjason 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT callaischeryl 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT waghmarealpana 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT chengguangshing 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT leisenringwendy 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT englundjanet 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation AT boeckhmichael 871symptomaticrespiratorysyncytialvirusandadenovirusupperrespiratorytractinfectionsincreasetheriskofinvasiveaspergillosisafterallogeneichematopoieticcelltransplantation |