Profilaksa infekcije respiratornim sincicijskim virusom s posebnim osvrtom na profilaksu u djece s prirođenim srčanim greškama

master's thesis

• Title (english): RSV prophylaxis with the accent on pediatric congenital heart patients
• Author: Ivona Sopta
• Mentor: Daniel Dilber (mentor)
• Committee member: Ivan Malčić (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Daniel Dilber (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Respiratorni sincicijski virus, virus pleomorfan po obliku i veličini, jedan je od najvažnijih i najčešćih uzročnika infekcija donjih dišnih puteva u dojenčadi i male djece. Rasprostranjen je po cijelom svijetu te pogađa sve dobne skupine pri čemu se najteže kliničke manifestacije infekcije susreću u ranoj dojenačkoj dobi (do šestog mjeseca života), u nedonoščadi, u djece s kroničnom plućnom bolesti te u djece s prirođenim srčanim grješkama. Većina djece preboli primofinfekciju do navršene druge godine života. Međutim, zbog anitigenske heterogenosti virusa, reinfekcije se mogu javljati tijekom cijeloga života, no one su tada obično blažeg kliničkog tijeka. U pripadnika mlađih dobnih skupina pretežno bivaju zahvaćeni donji dišni putevi te se infekcija klinički manifestira kao bronhiolitis ili pneumonija. Za razliku od njih, u veće djece i odraslih infekcija se najčešće očituje kao blaža infekcija gornjih dišnih puteva. Virus se redovito javlja svake godine u obliku većih ili manjih epidemija koje se u umjerenom klimatskom pojasu vremenski poklapaju sa zimom i ranim proljećem. Pojava epidemija je praćena porastom hospitalizacije dojenčadi i male djece zbog respiratornih bolesti. Pod velikim rizikom za razvoj izuzetno teških oblika bolesti popraćenih visokim morbiditetom i mortalitetom su nedonoščad, djeca s kroničnom plućnom bolesti te djeca s prirođenim srčanim greškama. Stoga, pripadnike prethodno nabrojanih skupina ubrajamo u tzv. populaciju pod rizikom. Zbog nepostojanja etiološke i ograničenja suportivne terapije, u svijetu se radi na proizvodnji prikladnog cjepiva kojim bi se spriječio razvoj infekcije te zaštitila ugrožena populacija. Međutim, u međuvremenu se u nekim područjima svijeta pribjeglo alternativi, pasivnom obliku zaštite ugrožene populacije od infekcije RSV-om, imunoprofilaksi palivizumabom čiji se pozitivni učinci tek trebaju ocijeniti.

Abstract (english)

Respiratory syncytial virus is a major cause of lower respiratory tract infections in infants and young children. It is prevalent worldwide and affects all age groups, but severe lower respiratory tract infections primarily occur in early neonatal period (up until 6 months of age), premature infants, in children with chronic lung disease as well as children with congenital heart defects. Most children overcome the primary infection up until the age of two. However, due to viral antigen heterogeneity, reinfections can occur throughout the entire lifespan, but then disease is milder than in infancy. Amongst the younger population, most of the infections occur in the lower respiratory tract where the infection will clinically appear as bronchiolitis or pneumonia. In comparison, in older children and adults the infection will most commonly manifest as a mild upper respiratory tract infection. The virus regularly appears every year either as big or small epidemics, which correlate in the moderate climate belt, during winter and early spring. The appearance of an epidemic is followed by an increased number of hospitalization of infants and small children due to respiratory diseases. The ones who are at increased risk of developing exceptionally severe form of the disease accompanied by high morbidity and mortality are premature infants, children with chronic lung diseases and children with congenital heart defects. For this reason the before mentioned groups are included in the so called population at risk. Due to nonexistence of etiological and restricted supportive therapy, there are now efforts worldwide to produce an appropriate vaccine that would prevent development of infection as well as protect the population at risk. However, in the meantime some parts of the world have resorted to an alternative, passive form of protection for the population at risk of the RSV; immune prophylaxis with palivizumab whose positive effects are yet to be graded.

• Keywords: respiratorni sincicijski virus; populacija pod rizikom; palivizumab; imunoprofilaksa
• Keywords (english): respiratory syncitial virus; population at risk; palivizumab; immunoprophylaxis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:319896
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-11 11:12:50