Allergy Asthma Immunol Res.  2017 Nov;9(6):491-498. 10.4168/aair.2017.9.6.491.

Prevalence of Respiratory Viral Infections in Korean Adult Asthmatics With Acute Exacerbations: Comparison With Those With Stable State

• Seo KH
• Bae DJ
• Kim JN
• Lee HS
• Kim YH
• Park JS
• Kim MS
• Chang HS
• Son JH
• Baek DG
• Lee JS
• Park CS

• KMID: 2421659
• DOI: http://doi.org/10.4168/aair.2017.9.6.491

Abstract

PURPOSE
Viral infections are involved in ~50% of exacerbations among Caucasian adult asthmatics. However, there have been few reports on the causative virus of exacerbations in Korean adult asthmatics. Thus, we compared frequencies and types of viruses between lower respiratory tract illnesses (LRTIs) with exacerbations (exacerbated LRTIs) and those without exacerbations (stable LRTIs) to evaluate contribution of respiratory viruses to exacerbations.
METHODS
Viral RNA was extracted from sputum using the Viral Gene-spinâ„¢ Kit. Reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect adenovirus (ADV), metapneumovirus (MPV), parainfluenza virus (PIV) 1/2/3, influenza virus (IFV) A, IFV B, respiratory syncytial virus (RSV) A/B, and rhinovirus (RV) A.
RESULTS
Among the 259 patients, 210 underwent a single sputum examination, and the remaining 49 underwent 2 to 4 sputum examinations. Virus was detected in 68 of the 259 exacerbated episodes and in 11 of the 64 stable episodes. Among the exacerbated episodes, RV was the most frequently detected virus, followed by influenza A, parainfluenza, RSV A/B, and ADV. Among the 11 stable episodes, RV was most frequently detected. Detection rates of these viruses did not differ between the 2 groups (P>0.05). Thirty-five patients underwent the virus examination at 2 episodes of exacerbation, while 14 patients underwent at each time of exacerbated and stable episodes. Virus detection rate at the second examination was significantly higher in cases with 2 exacerbation episodes than in those with initial exacerbation and sequential stable episodes (P=0.003). A seasonal pattern was noted in the detection rates of RV (September to December), IFV (January to April), PIV (May to September), and RSV A/B (September to April).
CONCLUSIONS
Respiratory viruses were identified in approximately 20% of LRTI irrespective of the presence of asthma exacerbation. RV and IFV A/B were most frequently detected. A group of patients experienced frequent viral infections followed by asthma exacerbations.

Keyword

Asthma; virus; exacerbation; season; sputum

MeSH Terms

Adenoviridae
Adult*
Asthma
Humans
Influenza, Human
Metapneumovirus
Orthomyxoviridae
Paramyxoviridae Infections
Prevalence*
Respiratory Syncytial Viruses
Respiratory System
Rhinovirus
RNA, Viral
Seasons
Sputum
RNA, Viral

Figure

• 

  Fig. 1 Virus detection rates (A) and frequencies (B) in cases with lower respiratory infections with exacerbated (n=259) and those with stable state (n=69). P values calculated by Pearson's χ2 test (A) and Fisher's exact test (B). P values for the rate of virus detection in the exacerbated and stable states were 0.213 (A) and 0.664 (B), respectively.

• 

  Fig. 2 Seasonal variation of respiratory virus in study cases. RV was prevalent in the fall, and IFV A was detected predominantly in January, February, and March. PIV was detected predominantly from May to September and RSV from September to April. RV, rhinovirus; IFV, influenza virus; PIV, parainfluenza virus; RSV, respiratory syncytial virus.

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