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Human metapneumovirus in lung transplant recipients and comparison to respiratory syncytial virus.
Am J Respir Crit Care Med. 2008 Oct 15; 178(8):876-81.AJ

Abstract

RATIONALE

Human metapneumovirus is a newly described virus isolated in 2001 from children with acute respiratory viral infection. It has subsequently been reported globally, although there are limited data in lung transplant recipients.

OBJECTIVES

To prospectively analyze whether human metapneumovirus was circulating in our adult lung transplant community and assess the morbidity of this infection and to compare the clinical presentation and outcome after intravenous ribavirin of human metapneumovirus with that of respiratory syncytial virus (RSV).

METHODS

Lung transplant patients with clinical features of respiratory viral infection underwent nasopharyngeal aspirates. Patients with a positive specimen for RSV or human metapneumovirus by reverse transcriptase-polymerase chain reaction analysis and graft dysfunction received intravenous ribavirin and pulse steroid therapy.

MEASUREMENTS AND MAIN RESULTS

Eighty-nine patients had 199 visits for aspirate studies. A viral cause was determined for 62 visits in 47 patients (19 human metapneumovirus, 18 RSV, 13 parainfluenza, 9 influenza A, 2 adenovirus, and 1 influenza B). A significant percentage of patients with metapneumovirus (63%) and RSV (72%) developed graft dysfunction, with average declines in FEV(1) of 30 +/- 12.4% and 25.9 +/- 11.2%, respectively. In these patients, bronchiolitis obliterans syndrome onset or progression occurred in no patients with human metapneumovirus compared with 5 of 13 (38%) patients with RSV at 6 months.

CONCLUSIONS

Human metapneumovirus is a leading cause of acute respiratory tract illness in lung transplant recipients. The incidence and clinical spectrum at presentation are similar to RSV, although the latter seems to be associated with a higher risk of chronic rejection. We recommend testing of nasopharyngeal aspirates for human metapneumovirus with polymerase chain reaction to assess local epidemiologic patterns.

Authors+Show Affiliations

Department of Respiratory Medicine, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Australia 4032. peterwakatipu@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18658110

Citation

Hopkins, Peter, et al. "Human Metapneumovirus in Lung Transplant Recipients and Comparison to Respiratory Syncytial Virus." American Journal of Respiratory and Critical Care Medicine, vol. 178, no. 8, 2008, pp. 876-81.
Hopkins P, McNeil K, Kermeen F, et al. Human metapneumovirus in lung transplant recipients and comparison to respiratory syncytial virus. Am J Respir Crit Care Med. 2008;178(8):876-81.
Hopkins, P., McNeil, K., Kermeen, F., Musk, M., McQueen, E., Mackay, I., Sloots, T., & Nissen, M. (2008). Human metapneumovirus in lung transplant recipients and comparison to respiratory syncytial virus. American Journal of Respiratory and Critical Care Medicine, 178(8), 876-81. https://doi.org/10.1164/rccm.200711-1657OC
Hopkins P, et al. Human Metapneumovirus in Lung Transplant Recipients and Comparison to Respiratory Syncytial Virus. Am J Respir Crit Care Med. 2008 Oct 15;178(8):876-81. PubMed PMID: 18658110.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Human metapneumovirus in lung transplant recipients and comparison to respiratory syncytial virus. AU - Hopkins,Peter, AU - McNeil,Keith, AU - Kermeen,Fiona, AU - Musk,Michael, AU - McQueen,Emily, AU - Mackay,Ian, AU - Sloots,Terry, AU - Nissen,Michael, Y1 - 2008/07/24/ PY - 2008/7/29/pubmed PY - 2008/10/22/medline PY - 2008/7/29/entrez SP - 876 EP - 81 JF - American journal of respiratory and critical care medicine JO - Am. J. Respir. Crit. Care Med. VL - 178 IS - 8 N2 - RATIONALE: Human metapneumovirus is a newly described virus isolated in 2001 from children with acute respiratory viral infection. It has subsequently been reported globally, although there are limited data in lung transplant recipients. OBJECTIVES: To prospectively analyze whether human metapneumovirus was circulating in our adult lung transplant community and assess the morbidity of this infection and to compare the clinical presentation and outcome after intravenous ribavirin of human metapneumovirus with that of respiratory syncytial virus (RSV). METHODS: Lung transplant patients with clinical features of respiratory viral infection underwent nasopharyngeal aspirates. Patients with a positive specimen for RSV or human metapneumovirus by reverse transcriptase-polymerase chain reaction analysis and graft dysfunction received intravenous ribavirin and pulse steroid therapy. MEASUREMENTS AND MAIN RESULTS: Eighty-nine patients had 199 visits for aspirate studies. A viral cause was determined for 62 visits in 47 patients (19 human metapneumovirus, 18 RSV, 13 parainfluenza, 9 influenza A, 2 adenovirus, and 1 influenza B). A significant percentage of patients with metapneumovirus (63%) and RSV (72%) developed graft dysfunction, with average declines in FEV(1) of 30 +/- 12.4% and 25.9 +/- 11.2%, respectively. In these patients, bronchiolitis obliterans syndrome onset or progression occurred in no patients with human metapneumovirus compared with 5 of 13 (38%) patients with RSV at 6 months. CONCLUSIONS: Human metapneumovirus is a leading cause of acute respiratory tract illness in lung transplant recipients. The incidence and clinical spectrum at presentation are similar to RSV, although the latter seems to be associated with a higher risk of chronic rejection. We recommend testing of nasopharyngeal aspirates for human metapneumovirus with polymerase chain reaction to assess local epidemiologic patterns. SN - 1535-4970 UR - https://www.unboundmedicine.com/medline/citation/18658110/Human_metapneumovirus_in_lung_transplant_recipients_and_comparison_to_respiratory_syncytial_virus_ L2 - http://www.atsjournals.org/doi/full/10.1164/rccm.200711-1657OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -