Published ahead of print on June 30, 2005, doi:10.1164/rccm.200502-315OC
Am. J. Respir. Crit. Care Med., Volume 172, Number 8, October 2005, 1037-1040
A more recent version of this article appeared on October 15, 2005
Submitted on February 28, 2005
Accepted on June 27, 2005
Rhinovirus Viremia in Children with Respiratory Infections
Maria Xatzipsalti1, Serena Kyrana1, Mariza Tsolia1, Stelios Psarras1, Apostolos Bossios1, Vasile Laza-Stanca2, Sebastian Johnston2, and Nikolaos G Papadopoulos1*
1 Department of Allergy, 2nd Pediatric Clinic, University of Athens, Athens, Greece,
2 National Heart and Lung Institute, Imperial College London, London, United Kingdom
* To whom correspondence should be addressed. E-mail: ngp{at}allergy.gr.
Rationale: Viremia has been implicated in many viral infections, however, viremia due to rhinovirus (RV, rhinoviremia) has been considered not to occur in normal individuals.
Objective: To evaluate whether RV enter the bloodstream and identify the possible risk factors.
Methods: Nasopharyngeal washes (NPW) of 221 children with respiratory infections were examined for the presence of RV by polymerase chain reaction (RT-PCR). Blood from 88 children, whose NPW was RV-positive, and 31 of RV-negative controls, was subsequently examined for the presence of RV in the blood by semi-nested RT-PCR. Rhinoviremia was then correlated with clinical characteristics of the disease.
Results: RV was detected in the blood of 10/88 NPW RV-positive cases (11.4%): 7/28 of children with asthma exacerbations (25.0%), 2/26 with common cold (7.7%), 1/25 with bronchiolitis (4.0%) and 0/9 with pneumonia (0%). All NPW RV-negative cases were negative in the blood. The proportion of rhinoviremia in children with asthma exacerbation was significantly higher compared to children suffering from the other diseases (25% vs 5%, p=0.01). Significant risk factors were: sampling 24 hours from symptom initiation, personal history of asthma and male sex. Age, fever, family and personal history of atopy did not affect the presence of RV in the blood.
Conclusions: Viremia may occur during RV respiratory infections in normal children and rather common in the early course of acute asthma exacerbations, suggesting that rhinoviremia may be involved in asthma exacerbation pathogenesis.
Key words: rhinovirus, viremia, respiratory infections, asthma, common cold
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