Publication | Open Access
Wheezing Rhinovirus Illnesses in Early Life Predict Asthma Development in High-Risk Children
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2009
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AsthmaRespiratory Virus ImmunityAllergyChildhood AsthmaPediatric EpidemiologyRespiratory DiseasesJackson DjRespiratory ComplicationsPediatricsRespiratory InfectionVirologyRhinovirus IllnessesPediatric Lung DiseaseInfectious Respiratory DiseaseAllergic RhinitisMedicineHigh-risk ChildrenHigh Risk
Virus-induced wheezing episodes in infancy often precede the development of asthma. The study aimed to define how specific viral wheezing illnesses in early childhood relate to asthma development by prospectively following 259 high‑risk children from birth to age 6. Researchers assessed viral etiology and timing of wheezing illnesses via nasal lavage, culture, and multiplex RT‑PCR, and analyzed their associations with asthma risk. Wheezing with RSV, RV, or both during early childhood increased asthma risk at age 6 (ORs 2.6, 9.8, 10), with RV wheezing in Year 1 (OR 2.8) and Year 3 (OR 25.6) being the strongest predictors, and nearly 90 % of children who wheezed with RV in Year 3 developed asthma by age 6, making RV the most significant predictor in this high‑risk cohort.
Virus-induced wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood.To define the relationship between specific viral illnesses and early childhood asthma development.A total of 259 children were followed prospectively from birth to 6 years of age. The etiology and timing of specific viral wheezing respiratory illnesses during early childhood were assessed using nasal lavage, culture, and multiplex reverse transcriptase-polymerase chain reaction. The relationships of these virus-specific wheezing illnesses and other risk factors to the development of asthma were analyzed.Viral etiologies were identified in 90% of wheezing illnesses. From birth to age 3 years, wheezing with respiratory syncytial virus (RSV) (odds ratio [OR], 2.6), rhinovirus (RV) (OR, 9.8), or both RV and RSV (OR , 10) was associated with increased asthma risk at age 6 years. In Year 1, both RV wheezing (OR, 2.8) and aeroallergen sensitization (OR, 3.6) independently increased asthma risk at age 6 years. By age 3 years, wheezing with RV (OR, 25.6) was more strongly associated with asthma at age 6 years than aeroallergen sensitization (OR, 3.4). Nearly 90% (26 of 30) of children who wheezed with RV in Year 3 had asthma at 6 years of age.Among outpatient viral wheezing illnesses in infancy and early childhood, those caused by RV infections are the most significant predictors of the subsequent development of asthma at age 6 years in a high-risk birth cohort.