RT Journal Article SR Electronic T1 Incidence and clinical impact of respiratory viruses in adults with cystic fibrosis JF Thorax JO Thorax FD BMJ Publishing Group Ltd and British Thoracic Society SP 247 OP 253 DO 10.1136/thoraxjnl-2013-204000 VO 69 IS 3 A1 William G Flight A1 Rowland J Bright-Thomas A1 Peter Tilston A1 Kenneth J Mutton A1 Malcolm Guiver A1 Julie Morris A1 A Kevin Webb A1 Andrew M Jones YR 2014 UL http://thorax.bmj.com/content/69/3/247.abstract AB Background Viral respiratory infection (VRI) is a common cause of pulmonary exacerbations in children with cystic fibrosis (CF). The importance of VRI in adult CF populations is unclear. Objective To determine the incidence and clinical impact of VRI among adults with CF. Methods One hundred adults with CF were followed up prospectively for 12 months. Sputum, nose swabs and throat swabs were collected every 2 months and at onset of pulmonary exacerbation. PCR assays for adenovirus, influenza A&B, human metapneumovirus, parainfluenza 1–3, respiratory syncytial virus and human rhinovirus were performed on each sample. Symptom scores, spirometry and inflammatory markers were measured at each visit. Results One or more respiratory viruses were detected in 191/626 (30.5%) visits. Human rhinovirus accounted for 72.5% of viruses. Overall incidence of VRI was 1.66 (95% CI 1.39 to 1.92) cases/patient-year. VRI was associated with increased risk of pulmonary exacerbation (OR=2.19; 95% CI 1.56 to 3.08; p<0.001) and prescription of antibiotics (OR=2.26; 95% CI 1.63 to 3.13; p<0.001). Virus-positive visits were associated with higher respiratory symptom scores and greater C-reactive protein levels. Virus-positive exacerbations had a lower acute fall in FEV1 than virus-negative exacerbations (12.7% vs 15.6%; p=0.040). The incidence of exacerbations, but not VRI, was associated with greater lung function decline over 12 months (−1.79% per pulmonary exacerbation/year; 95% CI −3.4 to −0.23; p=0.025). Conclusion VRI is common in adults with CF and is associated with substantial morbidity. Respiratory viruses are a potential therapeutic target in CF lung disease.