Dr. Laurent Kaiser

Two of 11 recipients infected with human rhinoviruses developed progressive respiratory and graft dysfunction leading to their deaths, reported Laurent Kaiser, M.D., of the University Hospital of Geneva, and colleagues.

The findings flout conventional wisdom holding that human rhinoviruses only infect the upper respiratory tract, the investigators wrote in the second December issue of the American Journal of Respiratory and Critical Care Medicine.

"The report by Dr. Kaiser and colleagues ends once and for all the argument that rhinovirus cannot infect the lower airways," wrote Marc B. Hershenson, M.D., of the University of Michigan in Ann Arbor, and Sebastian L. Johnston, M.D., Ph.D., of the National Heart and Lung Institute at Imperial College in London, in an accompanying editorial.
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Dr. Kaiser and colleagues looked at the occurrence of chronic rhinovirus infection in 69 lung transplant recipients at two centers.
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"In lung transplant recipients with severe immunosuppression, clinical rhinovirus infection needs to be considered," said Dr. Kaiser.

Laurent Kaiser, MD
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Applications with curriculum vitae, full list of publications and letter of interest should be addressed to Dr Laurent Kaiser, laurent.kaiser@hcuge.ch and copied to Christiane.Monnet-Biston@hcuge.ch at the Central Laboratory of Virology, University Hospitals of Geneva, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland (tel.: +41 22 372 4992).French is the official working language in Geneva.Closing date for applications is 31 May 2007.Laurent Kaiser, MDHead of the Laboratory

Two of 11 recipients infected with human rhinoviruses developed progressive respiratory and graft dysfunction leading to their deaths, reported Laurent Kaiser, M.D., of the University Hospital of Geneva, and colleagues.

Writing in the Dec. 1 issue of the American Journal of Respiratory and Critical Care Medicine, Laurent Kaiser, MD, of the department of medicine, division of infectious disease, University Hospitals of Geneva, Switzerland, analyzed the specimens for the presence of 11 different viruses, as well as several types of pneumonia plus Legionnaires†disease.

According to the authors, viruses in the lower respiratory tract are a leading cause of disease, hospitalization and antibiotic use in patients with immunosuppressive and/or chronic lung diseases.However, in 70 percent to 80 percent of the cases, the identity of the virus remains undetermined.

“This lack of diagnosis exists because appropriate lower respiratory tract samples are often not available and routine diagnostic procedures are limited both in their sensitivity and in the number of agents routinely targeted,†Dr. Kaiser said.

Laurent Kaiser, M.D., of the Central Laboratory of Virology at the University Hospital of Geneva, Switzerland, and 13 associates assessed the incidence of chronic rhinovirus infection and its potential clinical impact on 69 lung transplant recipients at two centers.Over a 19-month period, they screened all lung transplant patients using molecular analysis to detect 13 different respiratory viruses.Human rhinovirus is a leading cause of respiratory infections in adults and children.Adults, on average, get infected with the virus once per year.Lung transplant patients, with impaired immune systems due to drugs to halt rejection, are at potentially higher risk from the virus.

"Our evidence demonstrates that rhinoviral disease is not exclusively limited to the upper respiratory tract," said Dr. Kaiser."It can also lead to lower respiratory complications, which immunosuppressed patients can be at higher risk of developing."Although eight lung-transplant patients had transient rhinoviral infections, three showed a persistent infection.The others were able to clear the virus from their system."We confirmed the persistence of a single strain in each of three lung transplant recipients clinically infected by rhinovirus," said Dr. Kaiser."Two of the three had chronic upper respiratory tract infections.All three had relapsing lower respiratory infections, and two subsequently died with graft dysfunction."Dr. Kaiser noted that the persistent infection suggests that certain cases can act as viral reservoirs to sustain transmission of rhinovirus."Therefore, in lung transplant recipients with severe immunosuppression, clinical rhinovirus infection needs to be considered," said Dr. Kaiser.

Laurent Kaiser, M.D., of the Central Laboratory of Virology at the University Hospital of Geneva, and 13 associates assessed the incidence of chronic rhinovirus infection and its potential clinical impact on 69 lung transplant recipients at two centres.
...
Dr. Kaiser noted that the persistent infection suggests that certain cases can act as viral reservoirs to sustain transmission of rhinovirus.

Laurent Kaiser, M.D., of the Central Laboratory of Virology at the University Hospital of Geneva, Switzerland, and 13 associates assessed the incidence of chronic rhinovirus infection and its potential clinical impact on 69 lung transplant recipients at two centers.Over a 19-month period, they screened all lung transplant patients using molecular analysis to detect 13 different respiratory viruses.Human rhinovirus is a leading cause of respiratory infections in adults and children.Adults, on average, get infected with the virus once per year.Lung transplant patients, with impaired immune systems due to drugs to halt rejection, are at potentially higher risk from the virus."Our evidence demonstrates that rhinoviral disease is not exclusively limited to the upper respiratory tract," said Dr. Kaiser."It can also lead to lower respiratory complications, which immunosuppressed patients can be at higher risk of developing."

Although eight lung transplant patients had transient rhinoviral infections, three showed a persistent infection.The others were able to clear the virus from their system."We confirmed the persistence of a single strain in each of three lung transplant recipients clinically infected by rhinovirus," said Dr. Kaiser."Two of the three had chronic upper respiratory tract infections.All three had relapsing lower respiratory infections, and two subsequently died with graft dysfunction."Dr. Kaiser noted that the persistent infection suggests that certain cases can act as viral reservoirs to sustain transmission of rhinovirus."Therefore, in lung transplant recipients with severe immunosuppression, clinical rhinovirus infection needs to be considered," said Dr. Kaiser.

Laurent Kaiser, MD, of the Central Laboratory of Virology at the University Hospital of Geneva, and 13 associates assessed the incidence of chronic rhinovirus infection and its potential clinical impact on 69 lung transplant recipients at two centers.
...
"Our evidence demonstrates that rhinoviral disease is not exclusively limited to the upper respiratory tract," said Kaiser."It can also lead to lower respiratory complications, which immunosuppressed patients can be at higher risk of developing."

Although eight lung transplant patients had transient rhinoviral infections, three showed a persistent infection.The others were able to clear the virus from their system.

"We confirmed the persistence of a single strain in each of three lung transplant recipients clinically infected by rhinovirus," said Kaiser."Two of the three had chronic upper respiratory tract infections.All three had relapsing lower respiratory infections, and two subsequently died with graft dysfunction."

Kaiser noted that the persistent infection suggests that certain cases can act as viral reservoirs to sustain transmission of rhinovirus."Therefore, in lung transplant recipients with severe immunosuppression, clinical rhinovirus infection needs to be considered," said Kaiser.

Writing in the first issue for December 2004 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine, Laurent Kaiser, M.D., of the Department of Medicine, Division of Infectious Diseases, University Hospitals of Geneva, Geneva, Switzerland, analyzed the specimens for the presence of 11 different viruses, as well as several types of pneumonia plus Legionnaire's Disease.

"Respiratory viruses were identified in 34 of 117 BAL specimens (29 percent) obtained in patients with suspected respiratory infection and in only 2 of 31 control patients," said Dr. Kaiser.

The researchers used reverse transcription chain-reaction assay for their molecular analysis.

According to the authors, viruses in the lower respiratory tract are a leading cause of disease, hospitalization, and antibiotic use in patients with immunosuppressive and/or chronic lung diseases.However, in 70 to 80 percent of the cases, the identity of the virus remains undetermined.

"This lack of diagnosis exists because appropriate lower respiratory tract samples are often not available and routine diagnostic procedures are limited both in their sensitivity and in the number of agents routinely targeted," said Dr. Kaiser.
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"The sensitive molecular tool better estimated the frequency of respiratory viral infection in hospitalized patients and permitted the identification of the cause of a respiratory event in patients who did not respond to conventional empirical antibiotic treatment," said Dr. Kaiser.

Laurent Kaiser, University Hospitals of Geneva, Switzerland