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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
Down syndrome as risk factor for respiratory syncytial virus hospitalization: A prospective multicenter
Manuel Sánchez-Luna1, Constancio Medrano2, Julián Lirio3
1Neonatology Division, Hospital Materno Infantil, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
Insights
Infants with Down syndrome (DS) have higher hospitalization rates for respiratory syncytial virus (RSV) infections. These infants may benefit from RSV immunoprophylaxis recommendations.
Area of Science:
- Pediatrics
- Infectious Diseases
- Genetics
Background:
- Respiratory syncytial virus (RSV) poses a significant health risk, especially to infants.
- Premature infants are particularly vulnerable to severe RSV infection.
Purpose of the Study:
- To compare hospitalization rates and disease severity for RSV infections in term infants with and without Down syndrome (DS).
- To identify risk factors for severe RSV infection in infants.
Main Methods:
- A prospective, multicenter epidemiological study.
- 93 infants with DS and 68 matched controls were followed for one year.
- Data collected included hospitalization rates and RSV prophylaxis usage.
Main Results:
- Infants with DS had significantly higher hospitalization rates for acute respiratory infections (44.1% vs 7.7%) and RSV infections (9.7% vs 1.5%).
- RSV immunoprophylaxis was given to 35.5% of infants with DS.
- Hospitalization rates were lower in infants who received RSV prophylaxis (3.0% vs 15%).
Conclusions:
- Infants with Down syndrome experience a greater burden of RSV-related hospitalizations.
- Current recommendations for RSV immunoprophylaxis should consider including infants with DS.
Background:
Respiratory syncytial virus (RSV) infection in childhood, particularly in premature infants, is associated with significant morbidity and mortality.
Objectives:
To compare the hospitalization rates due to RSV infection and severity of disease between infants with and without Down syndrome (DS) born at term and without other associated risk factors for severe RSV infection.
Patients/Methods:
In a prospective multicentre epidemiological study, 93 infants were included in the DS cohort and 68 matched by sex and data of birth (±1 week) and were followed up to 1 year of age and during a complete RSV season.
Results:
The hospitalization rate for all acute respiratory infection was significantly higher in the DS cohort than in the non-DS cohort (44.1% vs 7.7%, P<.0001). Hospitalizations due to RSV were significantly more frequent in the DH cohort than in the non-DS cohort (9.7% vs 1.5%, P=.03). RSV prophylaxis was recorded in 33 (35.5%) infants with DS. The rate of hospitalization according to presence or absence of RSV immunoprophylaxis was 3.0% vs 15%, respectively.
Conclusions:
Infants with DS showed a higher rate of hospitalization due to acute lower respiratory tract infection and RSV infection compared to non-DS infants. Including DS infants in recommendations for immunoprophylaxis of RSV disease should be considered.
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