Abstract
Introduction: Community acquired respiratory virus (CARV) commonly infects patients following hematopoietic stem cell transplantation (HSCT), causing acute infection but also long-term decline in lung function, as a trigger to alloimmune lung syndrome. We conducted a 3-year case-control study to determine the effect of CARV detected by multiplex PCR on airflow decline.
Methods: The PFT (Pulmonary functional test) of symptomatic adult HSCT recipients who had a positive PCR for CARV between September 2012 and May 2015 were compared to PFT of those with negative PCR. The viruses detected were Influenza, Respiratory Syncytial Virus, Metapneumovirus, Coronavirus, Rhinovirus, Enterovirus, Parainfluenza, Adenovirus and Bocavirus.
Results: During the study period, 112 cases and 39 controls were considered. Cases underwent 179 infectious episodes confirmed by PCR, 40,7% were complicated by lower respiratory tract infection and 47,5% developed GVHD (Graft versus Host disease) post infection. Of 78 cases with positive PCR and complete PFTs, 42% developed persistent FEV-1 decline >5% more than 6 weeks after the episode, versus 18% in the control group (OR 3,35; CI 95% [0,063-0,42]; p = 0,009) and 23% developed persistent FEV-1 decline >10%, versus 7,7% in the control group (OR 3,60; CI 95% [0,062-0,030]; p = 0,041).
Conclusion: CARV infection were associated with long term airflow decline in adult HSCT recipients. The role of associated factors like type of virus, stem cell source, smoking status, lymphopenia, hypogammaglobulinemia, treatment by corticosteroids or other immunosuppressive drug, former GVHD or multiple infections will be evaluated in a multivariate analysis.
- Copyright ©the authors 2016
