title: Interference Between Respiratory Syncytial Virus and Human Rhinovirus Infection in Infancy.
abstract: BACKGROUND
  Respiratory syncytial virus (RSV) and human rhinovirus (HRV) are the most common viruses associated with acute respiratory tract infections in infancy. Viral interference is important in understanding respiratory viral circulation and the impact of vaccines.
  
  
  METHODS
  To study viral interference, we evaluated cases of RSV and HRV codetection by polymerase chain reaction in 2 prospective birth cohort studies (the Infant Susceptibility to Pulmonary Infections and Asthma Following RSV Exposure [INSPIRE] study and the Tennessee Children's Respiratory Initiative [TCRI]) and a double-blinded, randomized, controlled trial (MAKI), using adjusted multivariable regression analyses.
  
  
  RESULTS
  Among 3263 respiratory tract samples, 24.5% (798) and 37.3% (1216) were RSV and HRV positive, respectively. The odds of HRV infection were significantly lower in RSV-infected infants in all cohorts, with adjusted odds ratios of 0.30 (95% confidence interval [CI], .22-.40 in the INSPIRE study, 0.18 (95% CI, .11-.28) in the TCRI (adjusted for disease severity), and 0.34 (95% CI, .16-.72) in the MAKI trial. HRV infection was significantly more common among infants administered RSV immunoprophylaxis, compared with infants who did not receive immunoprophylaxis (OR, 1.65; 95% CI, 1.65-2.39).
  
  
  CONCLUSIONS
  A negative association of RSV on HRV codetection was consistently observed across populations, seasons, disease severity, and geographical regions. Suppressing RSV infection by RSV immunoprophylaxis might increase the risk of having HRV infection.
authors.affiliation: Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands.
authors.forename: Niek B
authors.initials: NB
authors.lastname: Achten
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine.
authors.forename: Pingsheng
authors.initials: P
authors.lastname: Wu
authors.affiliation: Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
authors.affiliation: Department of Pediatric Immunology and Infectious Diseases, University Medical Center Utrecht, the Netherlands.
authors.forename: Maarten O
authors.initials: MO
authors.lastname: Blanken
authors.affiliation: Department of Biostatistics.
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.affiliation: Department of Pathology, Microbiology, and Immunology, and.
authors.forename: James D
authors.initials: JD
authors.lastname: Chappell
authors.affiliation: Department of Biostatistics.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Biostatistics.
authors.forename: Chang
authors.initials: C
authors.lastname: Yu
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine.
authors.forename: Emma K
authors.initials: EK
authors.lastname: Larkin
authors.affiliation: Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee.
authors.forename: Kecia N
authors.initials: KN
authors.lastname: Carroll
authors.affiliation: Department of Pediatrics, Emory University, Atlanta, Georgia; and.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Anderson
authors.affiliation: Department of Pediatrics, Emory University, Atlanta, Georgia; and.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Moore
authors.affiliation: Department of Health Science, College of Life Sciences, Brigham Young University, Provo, Utah.
authors.forename: Chantel D
authors.initials: CD
authors.lastname: Sloan
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine.
authors.forename: Tina V
authors.initials: TV
authors.lastname: Hartert
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology*; D004198:Disease Susceptibility; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D000069455:Palivizumab / Q000627:therapeutic use; D010850:Picornaviridae Infections / Q000188:drug therapy / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy / Q000453:epidemiology*; D018113:Respiratory Syncytial Virus, Human; D012229:Rhinovirus; D014481:United States
chemical_list: D000998:Antiviral Agents; D000069455:Palivizumab
keywords: HRV; RSV; RV; Respiratory syncytial virus; infancy.; rhinovirus; viral interference