ABSTRACT

Introduction

Respiratory syncytial virus (RSV) causes approximately 120,000 deaths annually in children <5 years, with 99% of fatalities occurring in low- and middle-income countries (LMICs).

Areas covered

There are numerous RSV interventions in development, including long-acting monoclonal antibodies, vaccines (maternal and child) and treatments which are expected to become available soon. We reviewed the key challenges and issues that need to be addressed to maximize the impact of these interventions in LMICs. The epidemiology of RSV in LMICs was reviewed (PubMed search to 30 June 2020 inclusive) and the need for more and better-quality data, encompassing hospital admissions, community contacts, and longer-term respiratory morbidity, emphasized. The requirement for an agreed clinical definition of RSV lower respiratory tract infection was proposed. The pros and cons of the new RSV interventions are reviewed from the perspective of LMICs.

Expert opinion

We believe that a vaccine (or combination of vaccines, if practicable) is the only viable solution to the burden of RSV in LMICs. A coordinated program, analogous to that with polio, involving governments, non-governmental organizations, the World Health Organization, the manufacturers and the healthcare community is required to realize the full potential of vaccine(s) and end the devastation of RSV in LMICs.

中文翻译：

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在低收入和中等收入国家儿童中使用新兴药物预防或治疗 RSV 的挑战

摘要

介绍

呼吸道合胞病毒 (RSV) 每年导致大约 120,000 名 5 岁以下儿童死亡，其中 99% 的死亡发生在低收入和中等收入国家 (LMIC)。

覆盖区域

有许多 RSV 干预措施正在开发中，包括长效单克隆抗体、疫苗（母婴）和有望很快面世的治疗方法。我们审查了需要解决的主要挑战和问题，以最大限度地发挥这些干预措施对中低收入国家的影响。审查了 LMIC 中 RSV 的流行病学（PubMed 搜索到 2020 年 6 月 30 日，包括在内），并强调需要更多和质量更好的数据，包括住院、社区接触和长期呼吸道发病率。提出了对 RSV 下呼吸道感染达成一致的临床定义的要求。从中低收入国家的角度审查了新 RSV 干预措施的利弊。

专家意见

我们相信疫苗（或疫苗组合，如果可行）是解决中低收入国家 RSV 负担的唯一可行解决方案。需要一个类似于脊髓灰质炎的协调计划，涉及政府、非政府组织、世界卫生组织、制造商和医疗保健界，以实现疫苗的全部潜力并结束 RSV 在中低收入国家的破坏。