title: Detection of human rhinoviruses in the lower respiratory tract of lung transplant recipients.
abstract: The occurrence of human rhinoviruses (HRV) and its relationship to clinical and histopathological findings were investigated in 127 bronchoalveolar lavage specimens from 36 lung transplant recipients by real-time RT-PCR. In addition, 286 samples from 235 other immunocompromised and immunocompetent patients were also studied. HRV was detected in 41.7% of lung transplant recipients vs 14.5% of other patients (p < 0.0001), and no differences in viral load were observed. Acute respiratory insufficiency was found in 15 cases, three of which were HRV positive (viral load, 6.3 x 10(6) RNA copies/ml in one patient with chronic graft dysfunction). A diagnosis of pneumonia was made in 10 out of 127 cases, two of which were HRV positive (viral load, 10(3)-10(4) in cases of co-infection). Acute rejection was diagnosed in 12 cases, three of which were HRV positive (viral load, 10(3) in two cases of co-infection and 10(5) in a single infection). HRV infection may involve the lower respiratory tract, particularly in the presence of an impaired pulmonary background, such as a transplanted lung. Clinical evaluation should take into account the viral load, with a load of >10(5) possibly being associated with clinical symptoms, although lower loads can be detected in both symptomatic and asymptomatic patients.
authors.affiliation: Virology Unit, Department of Public Health and Microbiology, University Hospital San Giovanni Battista di Torino, University of Turin, via Santena 9, 10126, Turin, Italy. cristina.costa@unito.it
authors.forename: Cristina
authors.initials: C
authors.lastname: Costa
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Bergallo
authors.forename: Sara
authors.initials: S
authors.lastname: Astegiano
authors.forename: Francesca
authors.initials: F
authors.lastname: Sidoti
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Terlizzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Gambarino
authors.forename: Antonio
authors.initials: A
authors.lastname: Curtoni
authors.forename: Salvatore
authors.initials: S
authors.lastname: Simeone
authors.forename: Paolo
authors.initials: P
authors.lastname: Solidoro
authors.forename: Rossana
authors.initials: R
authors.lastname: Cavallo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008168:Lung / Q000821:virology*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D012229:Rhinovirus / Q000302:isolation & purification*; D019562:Viral Load; D055815:Young Adult