Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI), hospital admission, and mortality in children worldwide. Early-life RSV LRTI has also been associated with subsequent long-term respiratory sequelae, including recurrent LRTI, recurrent wheezing, asthma, and lung function impairment, and these effects can persist into adulthood as chronic respiratory disease. New preventive measures (maternal vaccine or long-acting monoclonal antibodies) have been licensed to reduce the burden of acute RSV LRTI in infants and children at high risk through passive immunisation. Studies of these RSV prevention products show high efficacy and effectiveness, particularly for preventing severe RSV LRTI, with implementation in many high-income countries, but limited access in low-income and middle-income countries (LMICs). These interventions might also reduce the risk of additional health outcomes and long-term morbidity. This Series paper provides the evidence for the long-term effects of early-life RSV disease, discusses mechanisms of disease development, and addresses the potential full public health value of prevention of RSV illness. Further research is needed to determine whether prevention of RSV LRTI or delay of RSV illness in early life might prevent or ameliorate the development of associated long-term respiratory disease. This potential further underscores the urgency for access and availability of new interventions to prevent early-life RSV LRTI in LMICs.

中文翻译：

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早期呼吸道合胞病毒病和长期呼吸健康


呼吸道合胞病毒 （RSV） 是全球儿童下呼吸道感染 （LRTI）、住院和死亡的主要原因。早期 RSV LRTI 也与随后的长期呼吸系统后遗症有关，包括复发性 LRTI、复发性喘息、哮喘和肺功能损害，这些影响可以作为慢性呼吸系统疾病持续到成年。新的预防措施（母体疫苗或长效单克隆抗体）已获得批准，可通过被动免疫减轻高危婴儿和儿童的急性 RSV LRTI 负担。对这些 RSV 预防产品的研究表明，这些产品具有很高的疗效和有效性，特别是在预防严重的 RSV LRTI 方面，在许多高收入国家实施，但在低收入和中等收入国家 （LMIC） 的可及性有限。这些干预措施还可能降低其他健康结局和长期发病率的风险。本系列论文为早期 RSV 疾病的长期影响提供了证据，讨论了疾病发展的机制，并讨论了预防 RSV 疾病的潜在全部公共卫生价值。需要进一步的研究来确定预防 RSV LRTI 或延迟早期 RSV 疾病是否可以预防或改善相关长期呼吸系统疾病的发展。这种潜力进一步强调了获取和提供新干预措施以预防低收入和中等收入国家早期 RSV LRTI 的紧迫性。