Detection of respiratory syncytial virus in adults with chronic obstructive pulmonary disease.
BACKGROUND
Recently, respiratory syncytial virus (RSV) RNA has been identified by reverse transcriptase-polymerase chain reaction (RT-PCR) from a high percentage of patients with stable chronic obstructive pulmonary disease (COPD). These data raise the possibility of persistent low-grade infection in this population, which could have implications in COPD pathogenesis.


OBJECTIVE
RSV persistence was investigated by testing respiratory secretions from subjects with COPD during illness and at regular intervals over 1 yr.


METHODS
Nasal and sputum samples from subjects with COPD were tested by one-tube nested RT-PCR for RSV every 2 mo and during respiratory illnesses for 1 yr. Subjects positive for RSV were evaluated weekly until negative in two consecutive samples. Nasal secretions and serum were tested for RSV antibody. A rise of fourfold or greater was defined as evidence of RSV infection.


RESULTS
A total of 112 patients were enrolled and the illnesses of 92 patients were evaluated. RSV was detected by RT-PCR in 6/92 (6.5%) illness nasal samples versus 0/685 routine nasal samples and in 5/69 (7.2%) illness sputum samples versus 3 /315 (0.9%) routine. Four additional RSV infections were identified by serum antibody responses. Of the RSV infections 86% were associated with serum or nasal antibody responses and 73% had symptoms of acute respiratory illness.


CONCLUSIONS
Most RSV infections in patients with COPD are associated with symptomatic respiratory illnesses and measurable immune responses. Our data do not support the concept of RSV persistence in this population.
Falsey
Ann R
AR
Infectious Diseases Unit, Department of Medicine, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY 14621, USA. ann.falsey@viahealth.org
Formica
Maria A
MA
Hennessey
Patricia A
PA
Criddle
Mary M
MM
Sullender
Wayne M
WM
Walsh
Edward E
EE
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000821:virology; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000821:virology*; D012367:RNA, Viral / Q000032:analysis*; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000821:virology*; D012136:Respiratory Syncytial Viruses / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
D000914:Antibodies, Viral; D012367:RNA, Viral