TY - JOUR
T1 - Respiratory Syncytial Virus, Human Metapneumovirus, and Parainfluenza Virus Infections in Lung Transplant Recipients
T2 - A Systematic Review of Outcomes and Treatment Strategies
AU - de Zwart, Auke
AU - Riezebos-Brilman, Annelies
AU - Lunter, Gerton
AU - Vonk, Judith
AU - Glanville, Allan R
AU - Gottlieb, Jens
AU - Permpalung, Nitipong
AU - Kerstjens, Huib
AU - Alffenaar, Jan-Willem
AU - Verschuuren, Erik
N1 - © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.
PY - 2022/6/15
Y1 - 2022/6/15
N2 - BACKGROUND: Respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (hMPV) are increasingly associated with chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTR). This systematic review primarily aimed to assess outcomes of RSV/PIV/hMPV infections in LTR and secondarily to assess evidence regarding the efficacy of ribavirin.METHODS: Relevant databases were queried and study outcomes extracted using a standardized method and summarized.RESULTS: Nineteen retrospective and 12 prospective studies were included (total 1060 cases). Pooled 30-day mortality was low (0-3%), but CLAD progression 180-360 days postinfection was substantial (pooled incidences 19-24%) and probably associated with severe infection. Ribavirin trended toward effectiveness for CLAD prevention in exploratory meta-analysis (odds ratio [OR] 0.61, [0.27-1.18]), although results were highly variable between studies.CONCLUSIONS: RSV/PIV/hMPV infection was followed by a high CLAD incidence. Treatment options, including ribavirin, are limited. There is an urgent need for high-quality studies to provide better treatment options for these infections.
AB - BACKGROUND: Respiratory syncytial virus (RSV), parainfluenza virus (PIV), and human metapneumovirus (hMPV) are increasingly associated with chronic lung allograft dysfunction (CLAD) in lung transplant recipients (LTR). This systematic review primarily aimed to assess outcomes of RSV/PIV/hMPV infections in LTR and secondarily to assess evidence regarding the efficacy of ribavirin.METHODS: Relevant databases were queried and study outcomes extracted using a standardized method and summarized.RESULTS: Nineteen retrospective and 12 prospective studies were included (total 1060 cases). Pooled 30-day mortality was low (0-3%), but CLAD progression 180-360 days postinfection was substantial (pooled incidences 19-24%) and probably associated with severe infection. Ribavirin trended toward effectiveness for CLAD prevention in exploratory meta-analysis (odds ratio [OR] 0.61, [0.27-1.18]), although results were highly variable between studies.CONCLUSIONS: RSV/PIV/hMPV infection was followed by a high CLAD incidence. Treatment options, including ribavirin, are limited. There is an urgent need for high-quality studies to provide better treatment options for these infections.
U2 - 10.1093/cid/ciab969
DO - 10.1093/cid/ciab969
M3 - Review article
C2 - 35022697
SN - 1058-4838
VL - 74
SP - 2252
EP - 2260
JO - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
IS - 12
ER -