Ribavirin for respiratory syncytial virus bronchiolitis reduced the risk of asthma and allergen sensitization.
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.
Chen
Chien-Han
CH
Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
Lin
Yu-Tsan
YT
Yang
Yao-Hsu
YH
Wang
Li-Chieh
LC
Lee
Jyh-Hong
JH
Kao
Chuan-Liang
CL
Chiang
Bor-Luen
BL
D000998:Antiviral Agents / Q000627:therapeutic use*; D001249:Asthma / Q000517:prevention & control*; D001990:Bronchiolitis, Viral / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D006967:Hypersensitivity / Q000517:prevention & control*; D007223:Infant; D008171:Lung Diseases / Q000150:complications; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000188:drug therapy*; D012254:Ribavirin / Q000627:therapeutic use*; D012306:Risk; D012307:Risk Factors; D013624:Taiwan; D013995:Time
D000998:Antiviral Agents; D012254:Ribavirin