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Chronic rhinoviral infection in lung transplant recipients.

Abstract：

RATIONALE:Lung transplant recipients are particularly at risk of complications from rhinovirus, the most frequent respiratory virus circulating in the community. OBJECTIVES:To determine whether lung transplant recipients can be chronically infected by rhinovirus and the potential clinical impact. METHODS:We first identified an index case, in which rhinovirus was isolated repeatedly, and conducted detailed molecular analysis to determine whether this was related to a unique strain or to re-infection episodes. Transbronchial biopsies were used to assess the presence of rhinovirus in the lung parenchyma. The incidence of chronic rhinoviral infections and potential clinical impact was assessed prospectively in a cohort of 68 lung transplant recipients during 19 mo by screening of bronchoalveolar lavages. MEASUREMENTS AND MAIN RESULTS:We describe 3 lung transplant recipients with graft dysfunctions in whom rhinovirus was identified by reverse transcriptase-polymerase chain reaction in upper and lower respiratory specimens over a 12-mo period. In two cases, rhinovirus was repeatedly isolated in culture. The persistence of a unique strain in each case was confirmed by sequence analysis of the 5'NCR and VP1 gene. In the index case, rhinovirus was detected in the lower respiratory parenchyma. In the cohort of lung transplant recipients, rhinoviral infections were documented in bronchoalveolar lavage specimens of 10 recipients, and 2 presented with a persistent infection. CONCLUSIONS:Rhinoviral infection can be persistent in lung transplant recipients with graft dysfunction, and the virus can be detected in the lung parenchyma. Given the potential clinical impact, chronic rhinoviral infection needs to be considered in lung transplant recipients.

journal_name

Am J Respir Crit Care Med

journal_title

American journal of respiratory and critical care medicine

authors

Kaiser L,Aubert JD,Pache JC,Deffernez C,Rochat T,Garbino J,Wunderli W,Meylan P,Yerly S,Perrin L,Letovanec I,Nicod L,Tapparel C,Soccal PM

doi

10.1164/rccm.200604-489OC

subject

Has Abstract

pub_date

2006-12-15 00:00:00

pages

1392-9

issue

12

eissn

1073-449X

issn

1535-4970

pii

200604-489OC

journal_volume

174

pub_type

杂志文章

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