Ribavirin for respiratory syncytial virus bronchiolitis reduced the risk of asthma and allergen sensitization

Pediatr Allergy Immunol. 2008 Mar;19(2):166-72. doi: 10.1111/j.1399-3038.2007.00610.x.

Abstract

Respiratory syncytial virus (RSV) bronchiolitis in early life is a risk factor for later development of asthma and atopy. Ribavirin is the only effective drug currently available against acute RSV bronchiolitis. However, the long-term effects of ribavirin remain unclear. We investigated a cohort of children hospitalized with RSV bronchiolitis from when they were under 2 yr old until they reached a mean age of 6.2 yr. In total, we enrolled 175 children in this study. Both the group treated with ribavirin and the group not treated with ribavirin included high-risk young children with congenital heart disease or chronic lung disease. Their respective age-matched controls, that we labeled groups A and B, both without ribavirin treatment, consisted of previously healthy subjects. Wheezing was either verified by physicians or estimated by a questionnaire. Allergen sensitization was judged by serum allergen-specific IgE levels. The cumulative incidence of physician-diagnosed asthma or recurrent wheezing in the ribavirin group (15%) was significantly lower than its incidence in the non-ribavirin-treated group (34%, p = 0.049), and in the control A group (43%, p = 0.005). Allergen sensitization was also least frequent in the ribavirin group. Ribavirin therapy was an independent factor in reducing the risk of developing asthma, asthma/recurrent wheezing, and sensitization to D. pteronyssinus/D. farinae. The long-term value of ribavirin for acute RSV bronchiolitis and its underlying mechanisms deserves further research.

Publication types

  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Asthma / prevention & control*
  • Bronchiolitis, Viral / complications
  • Bronchiolitis, Viral / drug therapy*
  • Child
  • Child, Preschool
  • Chronic Disease
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / complications
  • Humans
  • Hypersensitivity / prevention & control*
  • Infant
  • Lung Diseases / complications
  • Male
  • Respiratory Syncytial Virus Infections / complications
  • Respiratory Syncytial Virus Infections / drug therapy*
  • Ribavirin / therapeutic use*
  • Risk
  • Risk Factors
  • Taiwan
  • Time

Substances

  • Antiviral Agents
  • Ribavirin