Introduction:Although HRV is a common cause of benign upper respiratory infection, there are reports of HRV resulting in lower respiratory tract infection (LRTI) in HSCT and lung transplant recipients. However, there is a paucity of data on the HRV in LRTI disease in other types of transplant recipients. We describe characteristics of transplant patients with HRV infection compared to immunocompetent controls at an academic hospital.

Methods: Data was abstracted from 130 patients with positive HRV PCR from 2012-2014. The group was subdivided into HSCT or SOT recipients and immunocompetent controls. Thirty-six non-transplant immunocompromised patients were excluded. Fisher's exact test and Mann-Whitney U test were used for statistical analysis.

Results: 70 transplant recipients (12 heart, 11 lung, 7 kidney, 3 liver, 37 HSCT) were compared to 24 controls. The transplant group had a median age of 53 y/o compared to 50 y/o in controls. Comorbidities were equivalent except for an increase in asthmatics in the control group(p=0.003). Symptoms including fever, cough, sore throat, and myalgias were similar in the two groups except for SOB(p=0.004), chills (p=0.008)and headache (p=0.04)in controls. 25 transplant recipients were hospitalized including 13 HSCT and 12 SOT – 7 kidney, 2 liver, 2 heart and 1 lung. Transplant recipients had unilateral or bilateral infiltrates in 40% vs 50% of controls. Median hospital length of stay (LOS) was 16 days in the transplant group (range: 2-88 days) compared to controls with a median of 5 days (range: 3-62 days), p=0002. A higher proportion of controls required ICU care vs transplant recipients (42% versus 11%, respectively; p=0.02); however, the median ICU LOS was longer in the transplant group compared to controls (8 days vs 3 days, p=0.02). Ventilatory support was similar in both groups (12% in transplant recipients, 13% of controls). There was one death in a transplant recipient with no deaths in controls.

Conclusion: Transplant recipients with RHV infections present with similar symptoms as controls; however, when hospitalized, they have a longer LOS. All control patients were hospitalized, reflecting testing bias. Clinicians and patients should have a heightened awareness of the potential severity of progression to LTRI in transplant recipients.

CITATION INFORMATION: Crossman H, Barron M, Levi M. Characteristics of Human Rhinovirus (HRV) Infections in Transplant Recipients. Am J Transplant. 2016;16 (suppl 3).

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