| Objective: To expand our understanding of the viral epidemiology in different agedchildren with acute respiratory tract infection in Sochow area. Compare clinicalcharacteristics between HBoV infection alone group and mixed infection group. To study thecorrelation between the viral load of HBoV and clinical characteristics in children withacute respiratory tract infection.Methods:15238nasopharyngeal secretion samples were collected from hospitalizedchildren with acute respiratory infection,admitted from January2009to December2013,we tested respiratory syncytial virus,influenza A and B, parainfluenze virus1to3, andadenovirus by direct fluorescent antibody test. These specimens also were assayed forHBoV by polymerse chian reaction （real-time PCR/real-time fluorescence quantitativePCR）, and MP by quantitation fluorescent PCR.15238hospitalized children’s clinicaldatas were collected from January2009to December2013.Results: Of the15238nasopharyngeal secretion samples,4502（29.54%） patientshad evidence of virus infection.Among them,2205cases（14.47%） were RSV infection,1175cases（7.71%） were HBoV infection,755cases（4.95%） were Pinf3infection,260cases（1.70%） were InfAinfections,193cases（1.27%） wereADV infections,130cases（0.85%）were Pinf1infections,62cases（0.41%）were InfB infections, and last,6cases（0.04%） were Pinf2infections. In different ages and different seasons, the kinds ofcommon viral pathogens are different.The age group of~24months had the highest viralpositive rate, while the age group of>60months had the lowest.The group of~6monthsand~12months were the high incidence age of RSV infection,7months~24months werethe high incidence age of HBoV infection,~36months were the high incidence age ofInfB,Pinf1and InfA infection, the age>36months were the high incidence age of ADVinfection, especially among~60months old children.The season of the highest viral positive rate was winter, while the lowest was autumn. The epidemic season of InfB wasspring,ADV,Pinf1and Pinf3was summer, HBoV is autumn, RSV and InfA was winter.7393cases group and88normal controls group’s specimens were detected byreal-time fluorescence quantitative PCR for HBoV from January to December2013,88normal controls were all negative, in cases group,654cases were tested HBoV positive,and the positive rate was8.85%, among them,295cases（45.11%） were single HBoVinfection,359cases（54.89%） coinfect with other respiratory virus. The median viral loadof HBoV simple infection group is3.29×105copies/ml,apparently higher than.the mixedinfection group’s3.36×103copies/ml. The age of HBoV simple infection group is youngerthan the mixed infection group,and also the hospitalization time of the simple infectiongroup is shorter than the mixed infection group; On clinical manifestations, wheezing anddyspnea were easily occurred in children with HBoV simple infection, while fever wasmore occured in children with HBoV mixed infection, but the two group have indifferenceon cough, rhinorrhoea/rhinobyon, vomiting/diarrhea, anhelation; On clinical diagnosis,thecases of severe pneumonia were more detected with HBoV simple infection, while thecases of lobar pneumonia were more detected with HBoV mixed infection, but the twogroup have no significant difference on bronchial pneumonia, upper respiratory tractinfection,Acute bronchitis, pneumonia, acute episoded asthma/asthma co-infection; Onlaboratory studies, The median account of white cell、the ratio of neutrophilic granulocyte、the median account of CRP of the HBoV simple infection were similar to the HBoV mixedinfection, while the median account of platelets of the HBoV simple infection were higherthan those of HBoV mixed infection. Among the HBoV-positive cases,359casescoinfected with other respiratory virus, including MP（86.35%）、RSV（13.09%）、Pinf-Ⅲ（3.90%）、Inf-A（3.34%）、ADV（2.23%）、Pinf-I（1.67%）,and theirs median viralload respectively were2.27×104copies/ml、2.13×103copies/ml、1.0×103copies/ml、1.0×103copies/ml、8.88×106copies/ml、4.85×103copies/ml,the median viral load of HBoVmixed infection with Pinf-1was higher than others..Among the HBoV-positive cases,295cases （45.11%） were single HBoVinfection,and theirs high incidence age was7months~24months.Among the HBoV simpleinfection group,the rate of HBoV with high viral load was61.02%（180/295）, and the lowviral load was38.98%（115/295）, the difference between them is significative. HBoV with high viral load cases and with low viral load cases were no significative in age andhospitalization time,while HBoV with high viral load cases’ course of disease were longerthan with low viral load cases.;On clinical manifestations, wheezing and anhelation wereeasily occurred in children with HBoV high viral load.On clinical diagnosis, the majoritycases were diagnosed bronchopneumonia,13cases of severe pneumonia were all detectedwith HBoV high viral load, while the cases of upper respiratory tract infection and Acutebronchitis were more detected with HBoV low viral load, the differences between them aresignificative. On laboratory studies, The median account of platelets and the medianaccount of CRP of the HBoV with high viral load group were similar to the low viral loadgroup, while the median account of white cell、the ratio of neutrophilic granulocyte of theHBoV with high viral load were higher than those of HBoV with low viral load.Conculsion:(1) HBoV is one of the most common viral pathogen of respiratory-tractdisease in children in Sochow area.(2) In different ages and different seasons, the kind andthe postitive detection rate of viral pathogens are different.(3) HBoV is popular throughoutthe year, the most epidemic season is autumn,the second is winter,7months~24monthswere the high incidence age of HBoV infection.(4) HBoV can cause infants wheeze, thelow viral load of HBoV is more easier mixed infection with other pathogens,while the highload of HBoV has able to cause disease alone.(5) The viral load of HBoV has positivecorrelation with the severity of illness. |
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