Clinical significance of respiratory virus detection in patients with acute exacerbation of interstitial lung diseases. (March 2018)

• Record Type: Journal Article
• Authors: Saraya, Takeshi; Kimura, Hirokazu; Kurai, Daisuke; Tamura, Masaki; Ogawa, Yukari; Mikura, Sunao; Sada, Mitsuru; Oda, Miku; Watanabe, Takayasu; Ohkuma, Kosuke; Inoue, Manami; Honda, Kojiro; Watanabe, Masato; Yokoyama, Takuma; Fujiwara, Masachika; Ishii, Haruyuki; Takizawa, Hajime
• Is Part Of: Respiratory medicine. Volume 136(2018)
• Page Start: 88
• Page End: 92
• Publication Date: 2018-03
• Subjects: Acute exacerbation -- Idiopathic interstitial pneumonia -- Virus detection -- Short term mortality -- IPF -- Non-IPF interstitial lung disease; BALF bronchoalveolar lavage fluid -- CMV cytomegalovirus -- CTD connective tissue disease -- HHV human herpes virus -- HMPV human metapneumovirus -- HPIV human parainfluenza viruses -- HRSV human respiratory syncytial virus -- HRV human rhinovirus -- ILDs interstitial lung diseases -- IIP idiopathic interstitial pneumonia -- IPF idiopathic pulmonary fibrosis -- PCR polymerase chain reaction -- UIP usual interstitial pneumonia; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2018.02.003
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: The impact of viral infections on acute exacerbations in idiopathic pulmonary fibrosis (IPF) and/or non-IPF interstitial lung disease (ILDs) has been scarcely described. Objectives: To elucidate the frequency of virus infections in patients with IPF or non-IPF ILDs including idiopathic interstitial pneumonia (IIP) or connective tissue disease (CTD)-associated pneumonia, and its influence on their short-term mortality. Methods: We prospectively enrolled adult patients with acute exacerbation of IPF and non-IPF ILDs who were admitted to the hospital during the last 3 years, and examined the respiratory samples obtained from nasopharyngeal, sputum, and bronchoalveolar lavage fluid. Results: A total of 78 patients were identified, consisting of 27 patients with acute exacerbation of IPF and 51 patients with non-IPF ILDs (IIP: n = 27, CTD-associated IP: n = 24). Of all patients, 15 (19.2%) had viruses detected in their respiratory samples including the human herpesvirus 7 (HHV7; n = 4) and cytomegalovirus (CMV) plus HHV7 (n = 3). The proportion of virus infections in the IPF and non-IPF ILDs groups was comparable. The Kaplan-Meier survival curves over 60 days revealed a lower survival probability in the virus positive group (n = 15, 60%) than in the virus negative group (n = 60, 83.3%, p < 0.05). However, the virus infection itself could not predict the 60-day survival probability using simple logistic regression analysis. Conclusions: Viral infections, mostly CMV or HHV7, were identified in both patients with acute exacerbation of IPF and non-IPF ILDs, but the clinical significance on short-term mortality or isolation itself from respiratory samples remains to be determined.