Recurrent and persistent respiratory tract viral infections in patients with primary hypogammaglobulinemia.
BACKGROUND
The occurrence of respiratory tract viral infections in patients with primary hypogammaglobulinemia has not been studied.


OBJECTIVE
We conducted a prospective 12-month follow-up study of respiratory tract infections in 12 adult patients with primary hypogammaglobulinemia.


METHODS
Nasal swab samples and induced sputum samples were taken at the onset of acute respiratory tract infection and every 3 months thereafter. Samples were tested for bacteria and viruses. PCR tests were performed for 15 respiratory tract viruses. In case the results for rhinovirus were positive, follow-up nasal swab samples were taken every 2 weeks until rhinoviral PCR results became negative. Patients completed symptom diaries, which were collected every month. The spouses of the patients served as healthy control subjects.


RESULTS
During the 12-month period, the 12 patients had 65 episodes of acute respiratory tract infections, and the 11 spouses had 12 acute episodes (P < .001). Respiratory tract viruses were found in sputum in 54% of the infections. Rhinovirus was the most common virus. In more than half of our patients, rhinoviral PCR results stayed positive for more than 2 months. The most long-acting persistence with the same rhinovirus was 4 months.


CONCLUSIONS
Despite adequate immunoglobulin replacement therapy, patients with primary hypogammaglobulinemia have increased susceptibility to respiratory tract viral infections. Rhinoviral infections are frequent and prolonged.
Kainulainen
Leena
L
Department of Pediatrics, Turku University Hospitals, Turku, Finland. leena.kainulainen@tyks.fi
Vuorinen
Tytti
T
Rantakokko-Jalava
Kaisu
K
Osterback
Riikka
R
Ruuskanen
Olli
O
D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications* / Q000821:virology; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000209:etiology; D012229:Rhinovirus / Q000302:isolation & purification; D013183:Sputum / Q000382:microbiology / Q000821:virology; D014777:Virus Diseases / Q000453:epidemiology*