Clinical correlation of influenza and respiratory syncytial virus load measured by digital PCR

PLoS One. 2019 Sep 3;14(9):e0220908. doi: 10.1371/journal.pone.0220908. eCollection 2019.

Abstract

Acute respiratory tract infections are a major cause of respiratory morbidity and mortality in pediatric patients worldwide. However, accurate viral and immunologic markers to predict clinical outcomes of this patient population are still lacking. Droplet digital PCR assays for influenza and respiratory syncytial virus (RSV) were designed and performed in 64 respiratory samples from 23 patients with influenza virus infection and 73 samples from 19 patients with RSV infection. Samples of patients with hematologic malignancies, solid tumors, or sickle cell disease were included. Clinical information from institutional medical records was reviewed to assess disease severity. Samples from patients with fever or respiratory symptoms had a significantly higher viral loads than those from asymptomatic patients. Samples from patients with influenza virus and RSV infection collected at presentation had significantly higher viral loads than those collected from patients after completing a course of oseltamivir or ribavirin, respectively. RSV loads correlated positively with clinical symptoms in patients ≤5 years of age, whereas influenza viral loads were associated with clinical symptoms, irrespective of age. Patients receiving antivirals for influenza and RSV had a significant reduction in viral loads after completing therapy. Digital PCR offers an effective method to monitor the efficacy of antiviral treatment for respiratory tract infections in immunocompromised hosts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antiviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • Coinfection
  • Female
  • Humans
  • Infant
  • Influenza A virus / genetics*
  • Influenza B virus / genetics*
  • Influenza, Human / diagnosis
  • Influenza, Human / drug therapy
  • Influenza, Human / virology*
  • Lymphopenia / diagnosis
  • Lymphopenia / etiology
  • Male
  • Real-Time Polymerase Chain Reaction
  • Reproducibility of Results
  • Respiratory Syncytial Virus Infections / diagnosis
  • Respiratory Syncytial Virus Infections / drug therapy
  • Respiratory Syncytial Virus Infections / virology*
  • Respiratory Syncytial Virus, Human / genetics*
  • Symptom Assessment
  • Treatment Outcome
  • Viral Load*
  • Young Adult

Substances

  • Antiviral Agents

Grants and funding

This work was supported by American Lebanese Syrian Associated Charities (ALSAC), St. Jude Children’s Research Hospital. There was no additional external funding received for this study.