Rationale Acute viral respiratory tract infections in children with cystic fibrosis (CF) are known causes of disease exacerbation. The role of viral infections during infancy is, however, less known, although early infancy is thought to be a crucial period for CF disease development.
We prospectively assessed symptomatic and asymptomatic viral detection in the first year of life in infants with CF and healthy controls.
Methods In a prospective cohort study, we included 31 infants with CF from the Swiss Cystic Fibrosis Infant Lung Development Cohort and 32 unselected, healthy infants from the Basel Bern Infant Lung Development Cohort and followed them throughout the first year of life. Respiratory symptoms were assessed by weekly telephone interviews. Biweekly nasal swabs were analysed for 10 different viruses and two atypical bacteria with real-time seven duplex PCR (CF=561, controls=712).
Measurements and results Infants with CF and healthy controls showed similar numbers of swabs positive for virus (mean 42% vs 44%; OR 0.91, 95% CI 0.66 to 1.26, p=0.6). Virus-positive swabs were less often accompanied by respiratory symptoms in infants with CF (17% vs 23%; OR 0.64, 95% CI 0.43 to 0.95, p=0.026). This finding was pronounced for symptomatic human rhinovirus detection (7% vs 11%; OR 0.52, 95% CI 0.31 to 0.9, p=0.02).
Conclusions Viral detection is not more frequent in infants with CF and respiratory symptoms during viral detection occur even less often than in healthy controls. It is likely an interplay of different factors such as local epithelial properties and immunological mechanisms that contribute to our findings.
- Cystic Fibrosis
- Paediatric Lung Disaese
- Viral Infection
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Contributors Conceived and designed project: EK, UF, NR, MH, PL. Performed the experiments: SK, MTB, MG. Analysis and interpretation of the data: IK, IM, MG, UF, MH, PL. Wrote the paper: IK, MM, MH, CK, PL. Data acquisition: IK, EK, IM, NS. Patient recruitment: EK, IM, NR, UF, PL. Critical review of the paper: all authors.
Funding The study was funded by the Swiss National Science Foundation (SNF 324730_144280/1, SNF 320030_159791), the Botnar Foundation and the German, Swiss and Austrian Society of Pediatric Pulmonology. Virus analyses were supported by BioMerieux. The funders had no role in study design, data collection and analysis,decision to publish or preparation of the manuscript.
Disclaimer The funders had no role in study design, data collection and analysis,decision to publish or preparation of the manuscript.
Competing interests None declared.
Ethics approval Ethics committee Bern, Switzerland.
Provenance and peer review Not commissioned; externally peer reviewed.
Collaborators Swiss Cystic Fibrosis Infant Lung Development (SCILD) cohort, current study group: Jürg Barben, MD, St. Gallen; Gaudenz Hafen, MD, Lausanne; Insa Korten, MD, Bern; Alexander Moeller, MD, Zürich; Anne Mornand, MD, Geneva; Dominik Müller-Suter, MD, Aarau; Isabelle Rochat MD, Lausanne; Florian Singer, MD, PhD, Zürich; Daniel Trachsel, MD, Basel; Sophie Yammine, MD, PhD, Bern; Maura Zanolari, MD, Bellinzona, Basel Bern Infant Lung Development (BILD) cohort, current study group: Pinelopi Anagnostopoulou, MD, Bern; Oliver Fuchs, MD, PhD, Bern; Olga Gorlanova, MD, Basel; Elena Proietti, MD, PhD, Zurich; Anne Schmidt, MD, PhD, London; Jakob Usemann, MD, Basel.
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