TY - JOUR T1 - Human rhinovirus infection during naturally occurring COPD exacerbations JF - European Respiratory Journal JO - Eur Respir J SP - 87 LP - 96 DO - 10.1183/09031936.00223113 VL - 44 IS - 1 AU - Sîobhán N. George AU - Davinder S. Garcha AU - Alexander J. Mackay AU - Anant R.C. Patel AU - Richa Singh AU - Raymond J. Sapsford AU - Gavin C. Donaldson AU - Jadwiga A. Wedzicha Y1 - 2014/07/01 UR - http://erj.ersjournals.com/content/44/1/87.abstract N2 - Human rhinovirus (HRV) infection is an important trigger of exacerbations of chronic obstructive pulmonary disease (COPD) but its role in determining exacerbation frequency phenotype or the time-course of HRV infection in naturally occurring exacerbations is unknown. Sputum samples from 77 patients were analysed by real-time quantitative PCR for both HRV (388 samples), and Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis (89 samples). Patients recorded worsening of respiratory symptoms on daily diary cards, from which exacerbations were identified. HRV prevalence and load at exacerbation presentation were significantly higher than in the stable state (prevalence 53.3% versus 17.2%, respectively; p<0.001) but 0% by day 35 post-exacerbation. HRV load was higher in patients with cold symptoms (p=0.046) or sore throats (p=0.006) than those without. 73% of bacterium-negative but HRV-positive exacerbations were bacterium-positive by day 14. Patients with HRV detected at exacerbation had a higher exacerbation frequency (interquartile range) of 3.01 (2.02–5.30) per year compared with patients without HRV (2.51 (2.00–3.51)) (p=0.038). HRV prevalence and load increased at COPD exacerbation, and resolved during recovery. Frequent exacerbators were more likely to experience HRV infection. Secondary bacterial infection is common after HRV infection, and provides a possible mechanism for exacerbation recurrence and a potential target for novel therapies. Increased HRV prevalence and load are aetiological factors in natural COPD exacerbations and frequent exacerbations http://ow.ly/tlscz ER -