Clinical and Humoral Correlates of Protection from RSV Infection in Hematopoietic Stem Cell Transplant Recipients

Résumé fourni par la source

Background Respiratory syncytial virus (RSV) frequently causes upper respiratory tract infections , lung disease , and mortality in hematopoietic cell transplant (HCT) recipients. Currently, little is understood about what clinical and immunologic factors increase a patient's risk of infection and what factors are protective against infection in immunocompromised patient populations. Methods This study analyzed clinical and serologic data from a prospective cohort of allogeneic HCT recipients (N=471) followed longitudinally with weekly blood draws and PCR surveillance for respiratory viruses to gain insight into correlates of protection for RSV. Nasal washes were analyzed by ELISA to determine levels of IgA antibodies to the RSV F protein stabilized in the prefusion conformation. Nasal washes and serum were analyzed by a plaque reduction neutralization assay to determine neutralizing antibody titers to RSV-A2. Results Sixteen out of 471 HCT recipients tested positive for RSV within the first 100 days post-transplant. Pre-transplant and post-transplant antibody titers in nasal washes and serum were not correlated with risk for PCR detection of RSV in the first 100 days post-transplant. However, in a time-varying analysis of serum neutralization titers to RSV, higher levels of antibody were associated with reduced level of risk for RSV infection (Figure 1). Conclusions Serum neutralizing antibody titers are correlated with protection from RSV infection in the early post-transplant period. These results support the role of strategies that boost neutralizing antibody levels develop for preventing infection in HCT recipients.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.