Table 2.
Summary of studies analyzing the potential association between new onset of bronchiolitis obliterans syndrome and/or obliterans bronchiolitis and respiratory viral infections in lung transplant recipients
| Reference | Virus‐positive cases (n = 201) | Virus‐negative cases (n = 757) | Type or number of viruses considered for this analysis | Statistical analysis if available | ||
|---|---|---|---|---|---|---|
| Total cases | No. (%) with BOS | Total no. of cases | Number (%) with BOS | |||
| 1 | 10 | 4 (40.0) | NA | NA | 8 | NA |
| 12 | 9 | 4 (44.4) | NA | NA | Adenovirus only | Cox proportional hazards p <0.0001 |
| 8 | 22 | 7 (32.0) | NA | NA | PIV only | NA |
| 14 | 3 | 3 (100.0) | NA | NA | Influenza only | NA |
| 7 | 21 | 13 (62.0) | 207 | NA | 8 | p = 0.27, 0.02 and 0.01 for BOS 1, 2 and 3, respectively |
| 21 | 9 | 2 (22.2) | 17 | 9 (52.9) | HMpV only | NA |
| 5 | 15 | 1 (6.7) | 28 | 3 (10.7) | 8 | p value = non significant |
| 6 | 37 | 2 (5.4) | NA | NA | HMpV and RSV only | NA |
| 29 | 26 | 6 (23.0) | 274 | 25 (9.1) | 13 | Rate of BOS higher among CARV‐positive group (Kaplan‐Meier curve; p = 0.01) |
| 34 | 161 | 10 (62.5) | 45 | NA | 16 | NA |
| Pooled cases | 50 | 9 (18) | 319 | 37 (11.6) | p = 0.242 | |
| 172 | 33 | NA | 186 | NA | 7 | Previous CARV infection does not predispose to OB/BOS (relative risk 1.1; 95% CI 0.52–2.3)3 |
CARV, community‐acquired respiratory viruses; BOS, broncholitis obliterans syndrome; OB, obliterans bronchiolitis.
1The analysis focuses on 16 virus‐positive cases initially diagnosed with acute rejection at 3 months.
2Statistical analysis performed, but number of BOS cases not provided.
3In a subset analysis, lower CARV infection predisposes to BOS3 (Cox proportional hazards regression model; RR 2.3, 95% CI 1.1–4.9).