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Outcomes of Infants Receiving Palivizumab Prophylaxis for Respiratory Syncytial Virus in Canada and Italy

2016; Lippincott Williams & Wilkins; Volume: 36; Issue: 1 Linguagem: Inglês

10.1097/inf.0000000000001340

1532-0987

Paolo Manzoni, Bosco Paes, Krista L. Lanctôt, A Dall’Agnola, Ian Mitchell, Sara Calabrese, Milena Maule, Elisa Girardi, Tetsuhiro Harimoto, Abby Li,

Congenital Diaphragmatic Hernia Studies

Background: Respiratory syncytial virus (RSV) infection frequently results in RSV-related hospitalization (RSVH) in young infants. We examined the outcomes of palivizumab recipients within the Canadian Registry (CARESS) and the Torino-Verona Italian Registry over the 2002–2014 RSV seasons. Methods: RSVHs were captured during the study seasons. Premature infants who received palivizumab (≤35 completed weeks’ gestational age; group1) were compared with infants given palivizumab for underlying disorders regardless of gestational age (group 2). Variables and between-group incidences were analyzed. Risk factors associated with RSVH were assessed by logistic regression. Results: A total of 14,468 palivizumab-exposed infants were enrolled (group 1, n = 9093; group 2, n = 4856; miscellaneous, n = 519). RSVH was significantly more frequent in group 2 (211/4856, 4.34%) versus group 1 infants (216/9093, 2.37% [relative risk 1.93; 95% confidence interval (CI): 1.60–2.33; P < 0.0001]). Infants with neuromuscular disorders (7.88%), airway anomalies (5.95%), bronchopulmonary dysplasia (4.75%) and hemodynamically significant congenital heart disease (4.10%) had the highest RSVH incidences. After multivariable logistic regression, only neuromuscular disease [odds ratio [OR] 4.29; 95% CI: 2.30–8.00; P < 0.01], airway anomalies (OR 3.23; 95% CI: 1.92–5.43; P < 0.01), Down syndrome (OR 2.25; 95% CI: 1.31–3.89; P < 0.01), hemodynamically significant congenital heart disease (OR 2.24; 95% CI: 1.52–3.31; P < 0.001), prematurity ≤28+6 completed weeks’ gestational age (OR 1.82; 95% CI: 1.29–2.58; P < 0.001) and bronchopulmonary dysplasia (OR 1.81; 95% CI: 1.31–2.50; P < 0.001) significantly predicted RSVH. No significant association was detected with the number of doses administered or the time elapsed after the previous dose. Conclusions: RSVH rates are higher in infants given palivizumab for reasons other than prematurity. It is uncertain whether these findings relate to inadequate current palivizumab dosing protocols or to a specific increased RSVH risk inherent in infants with severe underlying comorbidities.