Patients with IBD at increased risk for respiratory syncytial virus infection
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Key takeaways:
- Patients with inflammatory bowel disease had an increased risk for respiratory syncytial virus infection across all age groups.
- Risk factors included certain comorbidities and IBD medications.
VANCOUVER, British Columbia — Adult patients with inflammatory bowel disease are at increased risk for respiratory syncytial virus infection and hospitalization, especially those with comorbidities, according to data presented here.
“Respiratory syncytial virus, or RSV, is a common viral infection and accounts for about 1.4 million outpatient visits annually across the United States,” Ryan A. Smith, MD, a gastroenterology and hepatology fellow at the University of Wisconsin Hospitals and Clinics, told attendees at the ACG Annual Scientific Meeting. “More recently, there’s a growing body of literature surrounding the risks of RSV and the impact on morbidity and mortality in immunocompromised populations, although most of the studies out there are on organ transplant patients at this time.”
Smith continued: “There is a current gap in the knowledge on the risks of RSV infections in patients with inflammatory bowel disease.”
Using data from a multi-institutional research network TriNetX, Smith and colleagues conducted a retrospective cohort study from January 2007 to February 2023 to assess the risk for RSV among 206,475 individuals with IBD vs. 4,166,977 without IBD. After propensity-score matching, the final cohort included 198,305 individuals (mean age, 44 years; 54% women) in each group.
According to results, there were 675 cases of RSV in the IBD group and 80,648 cases in the non-IBD group. Patients with IBD older than 18 years had an increased risk for RSV infection (adjusted OR = 2.24; 95% CI, 1.96-2.55).
“This risk was present across all age spectrums — from our youngest cohort, which was our 18 to 49 year olds, to our older cohort over the age of 65,” Smith noted.
Among those with IBD, comorbidities that increased the risk for RSV included diabetes mellitus (aOR = 1.2; 95% CI, 1.007-1.44), chronic lung disease (aOR = 1.21; 95% CI, 1.06-1.39), cardiovascular disease (aOR = 1.18; 95% CI, 1.01-1.37) and chronic kidney disease (aOR = 1.52; 95% CI, 1.21-1.92).
In addition, IBD patients on 5-aminosalicylate acid (aOR = 1.77; 95% CI, 1.39-2.25) thiopurines or methotrexate (aOR = 3.06; 95% CI, 2.09-4.49) or anti-tumor necrosis factor therapy (aOR = 1.66; 95% CI, 1.1-2.52) were at increased risk for RSV infection.
Patients in the IBD group also were at higher risk for RSV-associated hospitalization (aOR = 1.36; 95% CI, 1.09-1.69), especially those aged 18 to 49 years (aOR = 1.73; 95% CI, 1.15-2.6) or 65 years or older (aOR = 1.43; 95% CI, 1.03-1.99). There was no difference between cohorts among those aged 50 to 64 years.
“Gastroenterology providers should educate their patients regarding the risks of RSV and, through shared decision-making, should strongly encourage those who are currently eligible to receive the RSV vaccine,” Smith concluded. “In the United States, there are currently two approved recombinant non-live RSV vaccines that were just recently approved within the last year for adults older than 60 years.”
He added, “Although inflammatory bowel disease patients have yet to be studied with these vaccines here, they are presumed to be safe for this population.”
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Smith RA, et al. Increased risk of respiratory syncytial virus among patients with inflammatory bowel disease. Presented at: ACG Annual Scientific Meeting; Oct. 20-25, 2023; Vancouver, British Columbia (hybrid meeting).
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