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RSV infection during infancy leads to higher childhood asthma risk

An RSV infection in healthy children during their first year of life increases the risk of subsequently developing asthma at age 5

Respiratory syncytial virus (RSV) is a viral pathogen that causes acute lower respiratory infection in young children. Global estimates reveal how the virus causes 6·6 million infections in those aged 0 – 6 months and over 45,000 deaths. Whether or not RSV infection during this vital period of lung development might subsequently lead to asthma is uncertain. INSPIRE was a surveillance study including children with or without an RSV infection (RSVI) during infancy. Monitoring of children took place over the next 5 years. The main hypothesis was that avoiding an RSVI during infancy reduces the risk of childhood asthma. The primary outcome was 5-year current diagnosed asthma and finding from the INSPIRE study have been recently published.

RSV infection and development of asthma

A total of 1741 children had available data during the first year of life. Among the entire cohort, 54% had an RSVI during that first year.

Over the next 5 years, absence of a RSVI led to a 26% lower risk of developing asthma (relative risk, RR = 0.74, 95% CI 0.58 – 0.94, p = 0.016). The authors estimated that 15% (95% CI 2·2-26·8) of current 5-year asthma cases could be prevented by avoiding a RSVI.

The researchers commented that among healthy children, not being infected with RSV in the first year of life was associated with a substantially reduced risk of developing childhood asthma. However, they recognise that their study was unable to establish a causal relationship.

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