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771
Can Human Bocavirus mRNA Detection Differentiate Acute Infection from Viral Shedding?

Session: Poster Abstract Session: Clinical Respiratory Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
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  • Background: Human Bocavirus (HBoV), a DNA virus in the family Parvoviridae, is frequently detected in patients with acute respiratory disease. However, it is also prevalent in asymptomatic children, thus its pathogenicity is unclear. We hypothesized that spliced viral capsid mRNA produced during active replication (i.e. pathogenic period) may be a better marker for acute infection than HBoV genomic DNA, which can be shed for weeks to months (i.e. non-pathogenic period) and may thus be less specific for acute disease. We compared prevalence of capsid mRNA and DNA in children with community-acquired pneumonia (CAP) and controls as part of the CDC Etiology of Pneumonia in the Community (EPIC) study.

    Methods: We enrolled hospitalized children <18 years with CAP (Jan 2010-June 2012) and controls (Feb 2011-June 2012) at the Utah site of the EPIC study; nasopharyngeal/oropharyngeal (NP/OP) specimens were obtained. HBoV mRNA and genomic DNA were quantified from NP/OP specimens. A spliced transcript for HBoV1-4 VP1/VP2 was targeted for mRNA detection.

    Results: We obtained NP/OP samples from 812 children with CAP (median age 2.2 years; interquartile age [IQR] 1.0-6.2) and 337 controls (median age 5.8 years; IQR 2.8-11).  HBoV DNA was detected in 114/812 (14.0%) cases and 30/337 (8.9%) controls (odds ratio [OR] 1.7; 95% CI 1.1-2.5); HBoV mRNA was detected in 21/812 (2.6%) cases and 2/337 (0.6%) controls (OR 4.4; 1.1-19). Following adjustment for age, enrollment month, and detection of other respiratory viruses, HBoV DNA was associated with CAP (adjusted OR [aOR] 2.0; 1.2-3.2) but mRNA had a stronger association (aOR 7.9; 1.7-36). When the analysis was restricted to children in whom no other viral or bacterial pathogens were detected, the association with DNA detection was similar (OR 2.2; 1.2-4.0; 25/140 cases, 22/240 controls), while the association of HBoV mRNA detection with CAP increased  (OR 14.5; 1.8-117; 8/140 cases, 1/240 controls).

    Conclusion: Detection of HBoV by spliced capsid mRNA was strongly associated with CAP in children while genomic DNA was associated, even after adjusting for age, season, and respiratory pathogen co-detection. HBoV mRNA detection may be a marker of acute,  infection and could be a useful diagnostic test.

    Robert Schlaberg, MD, MPH1,2, Krow Ampofo, MD3, Keith Tardif, PhD2, Chris Stockmann, MSc3, Keith Simmon, MS4, Weston Hymas, MS, MB(ASCP)2, Steven Flygare, MS5, Brett Kennedy, PhD5, Anne J. Blaschke, MD, PhD3, Karen Eilbeck, PhD4, Mark Yandell, PhD5, Anna M. Bramley, MPH6, Seema Jain, MD, MPH7 and Andrew Pavia, MD, FIDSA, FSHEA3, (1)Department of Pathology, University of Utah, Salt Lake City, UT, (2)ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, (3)Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT, (4)Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, (5)Department of Human Genetics, University of Utah, Salt Lake City, UT, (6)Centers for Disease Control and Prevention (CDC), Atlanta, GA, (7)Centers for Disease Control and Prevention, Atlanta, GA

    Disclosures:

    R. Schlaberg, Epoch Biosciences: Collaborator, Research reagents

    K. Ampofo, None

    K. Tardif, None

    C. Stockmann, None

    K. Simmon, None

    W. Hymas, None

    S. Flygare, None

    B. Kennedy, None

    A. J. Blaschke, None

    K. Eilbeck, None

    M. Yandell, None

    A. M. Bramley, None

    S. Jain, None

    A. Pavia, None

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