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Review
. 2018 Apr;163(4):845-853.
doi: 10.1007/s00705-017-3700-y. Epub 2018 Jan 11.

Regional, age and respiratory-secretion-specific prevalence of respiratory viruses associated with asthma exacerbation: a literature review

Xue-Yan Zheng  1 , Yan-Jun Xu  1 , Wei-Jie Guan  2 , Li-Feng Lin  3
Affiliations
Review

Regional, age and respiratory-secretion-specific prevalence of respiratory viruses associated with asthma exacerbation: a literature review

Xue-Yan Zheng et al. Arch Virol. 2018 Apr.

Abstract

Despite increased understanding of how viral infection is involved in asthma exacerbations, it is less clear which viruses are involved and to what extent they contribute to asthma exacerbations. Here, we sought to determine the prevalence of different respiratory viruses during asthma exacerbations. Systematic computerized searches of the literature up to June 2017 without language limitation were performed. The primary focus was on the prevalence of respiratory viruses, including AdV (adenovirus), BoV (bocavirus), CoV (coronavirus), CMV (cytomegalovirus), EnV (enterovirus), HSV (herpes simplex virus), IfV (influenza virus), MpV (metapneumovirus), PiV (parainfluenzavirus), RV (rhinovirus) and RSV (respiratory syncytial virus) during asthma exacerbations. We also examined the prevalence of viral infection stratified by age, geographic region, type of respiratory secretion, and detection method. Sixty articles were included in the final analysis. During asthma exacerbations, the mean prevalence of AdV, BoV, CoV, CMV, EnV, HSV, IfV, MpV, PiV, RV and RSV was 3.8%, 6.9%, 8.4%, 7.2%, 10.1%, 12.3%, 10.0%, 5.3%, 5.6%, 42.1% and 13.6%, respectively. EnV, MPV, RV and RSV were more prevalent in children, whereas AdV, BoV, CoV, IfV and PiV were more frequently present in adults. RV was the major virus detected globally, except in Africa. RV could be detected in both the upper and lower airway. Polymerase chain reaction was the most sensitive method for detecting viral infection. Our findings indicate the need to develop prophylactic polyvalent or polyvirus (including RV, EnV, IfV and RSV) vaccines that produce herd immunity and reduce the healthcare burden associated with virus-induced asthma exacerbations.

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Conflict of interest statement

Xue-yan Zheng declares that she had no conflict of interest. Yan-jun Xu declares that she had no conflict of interest. Li-feng Lin declares that he had no conflict of interest. Wei-jie Guan declares that he had no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Overall prevalence of viruses in patients with asthma
Fig. 3
Fig. 3
The prevalence of the five most common viruses in the stratified analysis A. The prevalence of the five most common viruses when stratified by age (adults vs. children). B. The prevalence of the five most common viruses when stratified by geographic region (from top to bottom: Africa, Oceania, American, Asia, and Europe). C. The prevalence of the five most common viruses when stratified by the type of respiratory tract sample analyzed (lower vs. upper airway). D. The prevalence of the five most common viruses when stratified by method of detection (from top to bottom: culture, IFA, ELISA, DFA, and PCR). The horizontal axis represents the prevalence (%) of individual viruses. PCR, polymerase chain reaction; IFA, indirect fluorescent antibody assay; DFA, direct fluorescent antibody assay; ELISA, enzyme-linked immunosorbent assay; RV, rhinovirus; AdV, adenovirus; BoV, bocavirus; CoV, coronavirus; CV, cytomegalovirus; EnV, enterovirus; HSV, herpes simplex virus; IfV, influenza virus; MpV, metapneumovirus; PiV, parainfluenzavirus (PiV); RSV, respiratory syncytial virus
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