Prevalence of human rhinovirus in children admitted to hospital with acute lower respiratory tract infections in Changsha, China

Abstract

Human rhinovirus (HRV) is a causative agent of acute respiratory tract infections. This study analyzed the prevalence and clinical characteristics of three HRV groups (HRV-A, -B, and -C) among 1,165 children aged 14 years or younger who were hospitalized with acute lower respiratory tract infection in China. PCR or reverse transcription-PCR was performed to detect 14 respiratory viruses in nasopharyngeal aspirates collected from September 2007 to August 2008 in Changsha, China. HRV was detected in 202 (17.3%) of the 1,165 children; 25.3% of the HRV-positive children were 13-36 months of age (χ(2) = 22.803, P = 0.000). HRV was detected year round and peaked between September and December. Fifty-three percent of the HRV-positive samples were also positive for other respiratory viruses; respiratory syncytial virus (RSV) was the most common secondary virus. Phylogenetic analysis using the VP4/VP2 region grouped the HRV-positive strains as follows: 101 HRV-A (50.0%), 21 HRV-B (10.4%), and 80 HRV-C (39.6%). HRV-A infections occurred predominantly in spring and autumn, and the peak prevalence of HRV-C was in early winter and late autumn. HRV-B infections were less common in spring (χ(2) = 31.914, P = 0.000). No significant difference in clinical severity or presentation was found between patients with HRV single infection and HRV co-detections. Furthermore, the clinical characterizations did not differ among the three HRV species. These results suggest that HRV-C is an important viral agent along with HRV-A and HRV-B and that among hospitalized children with acute lower respiratory tract infection in China, the three HRV genotypes have similar clinical characteristics.

Keywords: China; acute lower respiratory tract infections; child; human rhinovirus.

Figure 1

Age distribution of HRV in children with ALRTIs during a 1‐year study period.

Figure 2

Seasonal distribution of HRV in children with ALRTIs, September 2007 to October 2008.

Figure 3

Phylogenetic analysis of the VP4/VP2 region of the 188 HRV strains from nasopharyngeal aspirates. Phylogenetic trees were constructed by the neighbor‐joining method using MEGA3.1 and coxsackievirus (M17711) is indicated as the outgroup.The viral sequences in black solid rhombus were generated from GenBank; other reference sequences were obtained from the present study.