成年人呼吸道同胞性病毒感染:叙事性综述
Joanne G Wildenbeest1, David M Lowe2, Joseph F Standing3
1Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands.
The Lancet. Respiratory medicine
|September 12, 2024
概括
呼吸道同胞病毒 (RSV) 是对老年人健康的重大威胁,导致严重的呼吸道感染. 新疫苗提供保护,但实际有效性数据对于最佳使用和预防策略至关重要.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 呼吸道同胞性病毒 (RSV) 是一种常见的RNA病毒,影响所有年龄段,越来越多地被认为是成年人的主要病原体,特别是患有并发症的老年人.
- 对RSV的临床诊断具有挑战性,需要PCR等准确的测试方法,因为在较低的病毒载荷下,护理点测试具有局限性.
研究的目的:
- 突出RSV在成年人,特别是老年人中的重大疾病负担,并需要改进预防和治疗策略.
- 审查目前RSV诊断,治疗和新批准的老年人疫苗的现状.
- 强调评估真实世界的疫苗有效性和针对目标人群的新干预措施的必要性.
主要方法:
- 文献综述和对RSV发病率,住院率和成年人死亡率的流行病学数据的分析.
- 对老年人群中RSV的临床表现,诊断挑战和当前治疗方法的检查.
- 评估RSV疫苗的最新进展以及持续研究和评估的需要.
主要成果:
- 在老年人中,RSV占门诊呼吸道感染和住院病例的很大比例,重症监护室的入院率和死亡率很高.
- 在住院成年人中,严重的RSV疾病在老年患者患有并发病中更为常见,经常出现呼吸系统症状,但没有发烧.
- 在2023年,在60岁及以上的成年人中批准了三种用于预防RSV的新疫苗,在临床试验中证明了对严重疾病的良好保护.
结论:
- RSV对老年人来说构成相当大的健康风险,与流感相似,需要将观念转变为需要有针对性的预防和治疗的重大健康问题.
- 关于新批准的RSV疫苗在老年人,包括高风险小组中的有效性,现实世界的数据对于优化其使用至关重要.
- 需要对新型诊断和治疗方法进行进一步的严格评估,以确保在老龄化人口中改善RSV患者的治疗结果.
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