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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Viral lower respiratory tract infections and preterm infants' healthcare utilisation
Simon B Drysdale1, Mireia Alcazar-Paris, Theresa Wilson
1Division of Asthma, Allergy and Lung Biology, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK, simon.drysdale@kcl.ac.uk.
Insights
Respiratory syncytial virus (RSV) lower respiratory tract infections (LRTI) in premature infants significantly increase healthcare costs and utilization in both the first and second year after birth. Identifying high-risk infants is crucial for cost-effective interventions.
Area of Science:
- Pediatrics
- Infectious Diseases
- Health Economics
Background:
- Prematurely born infants are vulnerable to respiratory syncytial virus (RSV) and other viral lower respiratory tract infections (LRTI).
- Understanding the long-term healthcare burden of these infections is essential for resource allocation and intervention strategies.
Purpose of the Study:
- To compare the healthcare utilization and costs associated with RSV LRTI versus other viral LRTI in prematurely born infants.
- To assess these effects in the second year after birth compared to the first year.
Main Methods:
- Prospective follow-up of 13 infants with RSV LRTI, 21 with other viral LRTI, and 25 controls (no LRTI).
- Nasopharyngeal aspirates collected for LRTI diagnosis.
- Healthcare utilization and health-related costs were systematically determined for two years post-infection.
Main Results:
- Infants with RSV LRTI incurred significantly higher overall respiratory costs in both year 1 (mean £3,917 vs £24) and year 2 (mean £1,164 vs £61) compared to controls.
- Only the RSV group required respiratory admissions, with a 3.4% admission rate in year 2 (NNT 59).
Conclusions:
- RSV LRTI is associated with sustained increased healthcare utilization and costs in the first two years of life for premature infants.
- Cost-effectiveness of prophylaxis in the second year necessitates identification of a high-risk subgroup.
Unlabelled:
The aim of this study was to determine whether respiratory syncytial virus (RSV) and other viral lower respiratory tract infections (LRTI) in prematurely born infants were associated with similar effects on healthcare utilisation and related cost of care in the second compared to the first year after birth. Thirteen infants who had RSV LRTIs (RSV), 21 who had other viral LRTIs (other viral) and 25 had no viral LRTIs (no LRTI) were prospectively followed. Nasopharyngeal aspirates were collected whenever an infant had an LRTI regardless of whether it was in the hospital or in the community. Healthcare utilisation and the health-related cost of care were determined. Only the RSV group compared to the no LRTI group had higher overall respiratory costs in both year 1 (mean, £3,917 versus £24; p < 0.041) and year 2 (mean, £1,164 versus £61; p = 0.012). Only the RSV group required respiratory admissions; the RSV admission rate in year 2 was 3.4 % (number needed to treat 59).
Conclusion:
RSV LRTIs are associated with increased healthcare utilisation and cost of care in the first and second year; nevertheless, if prophylaxis is to be cost-effective in the second year, a high risk group needs to be identified.
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