Recurrent wheezing and asthma after bocavirus bronchiolitis

Area of Science:

• Pediatric Respiratory Medicine
• Virology
• Allergology

Background:

• Human bocavirus (HBoV) is an emerging cause of respiratory infections in young children.
• The long-term respiratory outcomes of HBoV-bronchiolitis, particularly the development of recurrent wheezing and asthma, remain unclear.
• Understanding these outcomes is crucial for managing pediatric respiratory illnesses.

Purpose of the Study:

• To investigate the mid-term respiratory outcomes of children previously hospitalized with HBoV-bronchiolitis.
• To compare the incidence of recurrent wheezing and asthma in HBoV-bronchiolitis patients versus those with Respiratory Syncytial Virus (RSV)-bronchiolitis.
• To assess the association between HBoV infection and the development of asthma and related allergic conditions.

Main Methods:

• A cohort study of 80 children (10 HBoV, 70 RSV) hospitalized for acute bronchiolitis between 2004-2009, followed up to age ≥4 years.
• Data collection included structured clinical interviews, spirometry, and skin prick tests for common allergens.
• Comparison of clinical outcomes, including recurrent wheezing, asthma prevalence, and allergic sensitization, between HBoV and RSV groups.

Main Results:

• All children with HBoV-bronchiolitis developed recurrent wheezing, and 50% had asthma by age 5-7 years.
• Asthma and current asthma were significantly more frequent in the HBoV group (OR=1.28 and OR=2.18, respectively) compared to the RSV group.
• No significant differences were observed in allergic rhinitis, atopic dermatitis, food allergy, or positive skin prick test proportions between the groups.

Conclusions:

• Severe HBoV-bronchiolitis in infancy is strongly associated with the development of asthma at 5-7 years of age.
• HBoV infection may predispose children to persistent wheezing and asthma, necessitating further research into underlying mechanisms.
• These findings underscore the importance of considering HBoV in the differential diagnosis of severe bronchiolitis and its long-term respiratory sequelae.