Frequent lower respiratory tract disease in hematological patients with parainfluenza virus type 3 infection

J Med Virol. 2021 Nov;93(11):6371-6376. doi: 10.1002/jmv.27243. Epub 2021 Aug 5.

Abstract

Human parainfluenza virus type 3 (HPIV-3) may cause lower respiratory tract infection disease (LRTI-D) after hematopoietic stem cell transplantation (HSCT). Most previous have studies focused on recipients of HSCT whereas data on characteristics and outcomes in patients with hematological malignancies (HMs) compared to non-hematological patients are limited. The prognostic value of viral load in respiratory specimens remains elusive. In a 2-year retrospective study, we determined the frequencies of LRTI-D in HM, HSCT, and in non-hematological patients, and HPIV-3 levels in respiratory tract secretions. Among 98 patients with HPIV-3 infection, including 31 HSCT and 40 HM, 36 had a diagnosis of LRTI-D. LRTI-D was significantly more frequent in patients with HM or HSCT (n = 32, 45.1%) than in non-hematological patients (n = 4, 14.8%) (p = 0.006). The median HPIV-3 loads were high in upper respiratory tract secretions regardless of the presence or absence of LRTI-D (8.3 log10 vs. 7.6 log10 TCID50 /106 cells). HPIV-3 loads in respiratory tract samples in HM were not significantly higher than those found in HSCT but significantly higher than in non-hematological patients (p = 0.007). In conclusion, LRTI-D was frequent in HM patients who were diagnosed with HPIV-3 infection.

Keywords: hematological malignancy; hematopoietic stem cell transplant; human parainfluenza virus type 3; lower respiratory tract disease; pneumonia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Hematologic Neoplasms / complications*
  • Hematopoietic Stem Cell Transplantation / adverse effects
  • Humans
  • Middle Aged
  • Parainfluenza Virus 3, Human / pathogenicity*
  • Paramyxoviridae Infections / virology*
  • Respiratory Tract Infections / virology*
  • Retrospective Studies
  • Transplantation, Homologous / adverse effects
  • Young Adult