Experience of passive immunoprophylaxis against respiratory syncytial viral infection in children born with very low and extremely low body weight

Introduction. The respiratory syncytial virus is one of the leading causes of lower respiratory tract infections in premature children. An effective way to prevent respiratory syncytial viral infection is passive immunization with palivizumab. However, its capabilities and results in children born with very low and extremely low body weight have not been sufficiently studied.

Objective. To evaluate the effectiveness of passive immunization in the prevention of respiratory syncytial viral infection in children born with very low and extremely low body weight.

Children characteristics and research methods. The authors studied the frequency and severity of respiratory diseases in 450 patients born with very low and extremely low body weight. 385 children (Group 1) received palivizumab, 65 children (Group 2) did not receive palivizumab. In both groups there was the same frequency of bronchopulmonary dysplasia (68,8 and 69,0%, respectively)

Results. There were no complications after palivizumab administration; 32 (8,3%) children had mild catarrhal phenomena without hyperthermia, 3 (0,8%) children had local skin reactions. During observation period up to 9±1 months the authors noted a lower incidence of respiratory diseases (p=0,0002) in Group 1 as compared with Group 2, including moderate forms of ARVI (p=0,0078); none of the children got sick due to the respiratory syncytial virus. In Group 2 the virus was detected in 3 out of 7 children with a severe respiratory infection. The immunized children were less likely to be hospitalized (p=0,0175), including in the intensive care unit and intensive care unit (p=0,0034) and to be prescribed antibiotic therapy (p=0,0045). There was the higher risk of recurrent diseases in both groups. The patients with bronchopulmonary dysplasia with comorbid conditions were at higher risk of recurrent diseases in both groups.

Conclusion. Children born with very low and extremely low body weight shall be given passive immunoprophylaxis against RSV infection.

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