Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections

Abstract Background Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct)...

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Veröffentlicht in:Open forum infectious diseases 2017-10, Vol.4 (suppl_1), p.S310-S310
Hauptverfasser: Beveridge, Stockton, Piya, Bhinnata, Stewart, Laura, Lindegren, Mary Louise, Markus, Tiffanie, Schaffner, William, Halasa, Natasha B
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container_title Open forum infectious diseases
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creator Beveridge, Stockton
Piya, Bhinnata
Stewart, Laura
Lindegren, Mary Louise
Markus, Tiffanie
Schaffner, William
Halasa, Natasha B
description Abstract Background Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses. Methods Children
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(IQR) p-value Days of Ilness - Median (IQR) p-value Respiratory Syncytial Virus (RSV) Single 144 25.5 (22.86-29.03) 0.05 4 (3-5) 0.82 RSV-Co-detection 63 27.0 (23.47-33.82) 3 (3-7) Human Rhinovirus (HRV)-Single 289 27.5 (23.79-32.50) 0.000 3 (2-4) 0.002 HRV-Co-detection 117 32.8 (29.08-35.49) 3 (2-6) Adenovirus (AdV)-Single 79 28.7 (23.84-33.62) 0.001 3 (2-4) 0.06 Adv-Co-detection 7 32.8 (27.40–36.69) 3 (2-4) Human metapneumovirus (HMPV)-Single 75 28.8 (25.37-32.22) 0.75 4 (3-6) 0.45 HMPV-Co-detection 30 28.2 (24.86-33.11) 4 (3-7) Parainfluenza (PIV)-Single 36 25.2 (23.75-28.76) 0.005 3.5 (2-5.5) 0.34 PIV-Co-detection 15 28.8 (26.04-34.50) 3 (1–4) Flu-Single 127 26.6 (24.71-30.51) 0.34 3 (2-5) 0.83 Flu-Co-detection 26 28.0 (25.98-30.14) 3.5 (2-6) Conclusion Single detection with RSV, HRV, AdV, and PIV had lower Ct values, indicating higher viral loads, compared with co-detection with other viruses. Additional research is needed to understand the reason for lower viral loads for co-detection vs. single detection in select respiratory viruses. Disclosures W. Schaffner, Pfizer: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Novavax: Consultant, Consulting fee. Dynavax: Consultant, Consulting fee. Sanofi-pasteur: Consultant, Consulting fee. GSK: Consultant, Consulting fee. Seqirus: Consultant, Consulting fee. N. B. Halasa, sanofi pasteur: Research Contractor, Research support. Astra Zeneca: Research Contractor, Grant recipient.</description><identifier>ISSN: 2328-8957</identifier><identifier>EISSN: 2328-8957</identifier><identifier>DOI: 10.1093/ofid/ofx163.723</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><ispartof>Open forum infectious diseases, 2017-10, Vol.4 (suppl_1), p.S310-S310</ispartof><rights>The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1623-6c3cc2d238631a31ec00af450d7d4a744103f5988a86f5683f1959fc7ecf65493</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids></links><search><creatorcontrib>Beveridge, Stockton</creatorcontrib><creatorcontrib>Piya, Bhinnata</creatorcontrib><creatorcontrib>Stewart, Laura</creatorcontrib><creatorcontrib>Lindegren, Mary Louise</creatorcontrib><creatorcontrib>Markus, Tiffanie</creatorcontrib><creatorcontrib>Schaffner, William</creatorcontrib><creatorcontrib>Halasa, Natasha B</creatorcontrib><title>Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections</title><title>Open forum infectious diseases</title><description>Abstract Background Molecular testing for respiratory viruses in clinical practice is common, often with multiple viruses detected. Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses. Methods Children &lt;18 years with respiratory symptoms and/or fever who presented to the ED or were admitted were enrolled. Nasal/throat specimens were obtained and combined. Singleplex qRT-PCR was used to test for 11 respiratory viruses. Clinical and demographic information were collected. Results From 11/15/15-7/15/16, 1255 children were enrolled, with median age of 26.5 months, 53.4% male, 54.3% White, 38.7% Black, 6.4% other, and 23.5% Hispanic. The median days of illness were 3 days. Of the total cohort, 904 (72%) tested positive for at least one viral pathogen. Table 1compares Ct values of single vs. co-detection for each individual virus. Table 1. N Ct-Median 
(IQR) p-value Days of Ilness - Median (IQR) p-value Respiratory Syncytial Virus (RSV) Single 144 25.5 (22.86-29.03) 0.05 4 (3-5) 0.82 RSV-Co-detection 63 27.0 (23.47-33.82) 3 (3-7) Human Rhinovirus (HRV)-Single 289 27.5 (23.79-32.50) 0.000 3 (2-4) 0.002 HRV-Co-detection 117 32.8 (29.08-35.49) 3 (2-6) Adenovirus (AdV)-Single 79 28.7 (23.84-33.62) 0.001 3 (2-4) 0.06 Adv-Co-detection 7 32.8 (27.40–36.69) 3 (2-4) Human metapneumovirus (HMPV)-Single 75 28.8 (25.37-32.22) 0.75 4 (3-6) 0.45 HMPV-Co-detection 30 28.2 (24.86-33.11) 4 (3-7) Parainfluenza (PIV)-Single 36 25.2 (23.75-28.76) 0.005 3.5 (2-5.5) 0.34 PIV-Co-detection 15 28.8 (26.04-34.50) 3 (1–4) Flu-Single 127 26.6 (24.71-30.51) 0.34 3 (2-5) 0.83 Flu-Co-detection 26 28.0 (25.98-30.14) 3.5 (2-6) Conclusion Single detection with RSV, HRV, AdV, and PIV had lower Ct values, indicating higher viral loads, compared with co-detection with other viruses. Additional research is needed to understand the reason for lower viral loads for co-detection vs. single detection in select respiratory viruses. Disclosures W. Schaffner, Pfizer: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Novavax: Consultant, Consulting fee. Dynavax: Consultant, Consulting fee. Sanofi-pasteur: Consultant, Consulting fee. GSK: Consultant, Consulting fee. Seqirus: Consultant, Consulting fee. N. B. Halasa, sanofi pasteur: Research Contractor, Research support. 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Viral load has been correlated with illness severity, but correlation of co-detection of viruses and viral load is less clear. We sought to compare cycle threshold (Ct) values, a marker inversely related to viral load, between single vs. co-detection of common respiratory viruses. Methods Children &lt;18 years with respiratory symptoms and/or fever who presented to the ED or were admitted were enrolled. Nasal/throat specimens were obtained and combined. Singleplex qRT-PCR was used to test for 11 respiratory viruses. Clinical and demographic information were collected. Results From 11/15/15-7/15/16, 1255 children were enrolled, with median age of 26.5 months, 53.4% male, 54.3% White, 38.7% Black, 6.4% other, and 23.5% Hispanic. The median days of illness were 3 days. Of the total cohort, 904 (72%) tested positive for at least one viral pathogen. Table 1compares Ct values of single vs. co-detection for each individual virus. Table 1. N Ct-Median 
(IQR) p-value Days of Ilness - Median (IQR) p-value Respiratory Syncytial Virus (RSV) Single 144 25.5 (22.86-29.03) 0.05 4 (3-5) 0.82 RSV-Co-detection 63 27.0 (23.47-33.82) 3 (3-7) Human Rhinovirus (HRV)-Single 289 27.5 (23.79-32.50) 0.000 3 (2-4) 0.002 HRV-Co-detection 117 32.8 (29.08-35.49) 3 (2-6) Adenovirus (AdV)-Single 79 28.7 (23.84-33.62) 0.001 3 (2-4) 0.06 Adv-Co-detection 7 32.8 (27.40–36.69) 3 (2-4) Human metapneumovirus (HMPV)-Single 75 28.8 (25.37-32.22) 0.75 4 (3-6) 0.45 HMPV-Co-detection 30 28.2 (24.86-33.11) 4 (3-7) Parainfluenza (PIV)-Single 36 25.2 (23.75-28.76) 0.005 3.5 (2-5.5) 0.34 PIV-Co-detection 15 28.8 (26.04-34.50) 3 (1–4) Flu-Single 127 26.6 (24.71-30.51) 0.34 3 (2-5) 0.83 Flu-Co-detection 26 28.0 (25.98-30.14) 3.5 (2-6) Conclusion Single detection with RSV, HRV, AdV, and PIV had lower Ct values, indicating higher viral loads, compared with co-detection with other viruses. Additional research is needed to understand the reason for lower viral loads for co-detection vs. single detection in select respiratory viruses. Disclosures W. Schaffner, Pfizer: Scientific Advisor, Consulting fee. Merck: Scientific Advisor, Consulting fee. Novavax: Consultant, Consulting fee. Dynavax: Consultant, Consulting fee. Sanofi-pasteur: Consultant, Consulting fee. GSK: Consultant, Consulting fee. Seqirus: Consultant, Consulting fee. N. B. Halasa, sanofi pasteur: Research Contractor, Research support. Astra Zeneca: Research Contractor, Grant recipient.</abstract><cop>US</cop><pub>Oxford University Press</pub><doi>10.1093/ofid/ofx163.723</doi><oa>free_for_read</oa></addata></record>
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title Comparison of Viral Loads in Patients with Co-infections vs. Single-virus Infections
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