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J Allergy Clin Immunol. 2010 Jul;126(1):120-6. doi: 10.1016/j.jaci.2010.04.016. Epub 2010 Jun 11.

Recurrent and persistent respiratory tract viral infections in patients with primary hypogammaglobulinemia.

Author information

1
Department of Pediatrics, Turku University Hospitals, Turku, Finland. leena.kainulainen@tyks.fi

Abstract

BACKGROUND:

The occurrence of respiratory tract viral infections in patients with primary hypogammaglobulinemia has not been studied.

OBJECTIVE:

We conducted a prospective 12-month follow-up study of respiratory tract infections in 12 adult patients with primary hypogammaglobulinemia.

METHODS:

Nasal swab samples and induced sputum samples were taken at the onset of acute respiratory tract infection and every 3 months thereafter. Samples were tested for bacteria and viruses. PCR tests were performed for 15 respiratory tract viruses. In case the results for rhinovirus were positive, follow-up nasal swab samples were taken every 2 weeks until rhinoviral PCR results became negative. Patients completed symptom diaries, which were collected every month. The spouses of the patients served as healthy control subjects.

RESULTS:

During the 12-month period, the 12 patients had 65 episodes of acute respiratory tract infections, and the 11 spouses had 12 acute episodes (P < .001). Respiratory tract viruses were found in sputum in 54% of the infections. Rhinovirus was the most common virus. In more than half of our patients, rhinoviral PCR results stayed positive for more than 2 months. The most long-acting persistence with the same rhinovirus was 4 months.

CONCLUSIONS:

Despite adequate immunoglobulin replacement therapy, patients with primary hypogammaglobulinemia have increased susceptibility to respiratory tract viral infections. Rhinoviral infections are frequent and prolonged.

PMID:
20541246
DOI:
10.1016/j.jaci.2010.04.016
[Indexed for MEDLINE]

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