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Bechini A, Salvati C, Bonito B, Del Riccio M, Stancanelli E, Bruschi M, Ionita G, Iamarino JA, Bentivegna D, Buscemi P, Ciardi G, Cosma C, Stacchini L, Conticello C, Bega M, Paoli S, Schirripa A, Bertizzolo L, Muzii B, Azzi MV, Parisi S, Trippi F, Bonanni P, Boccalini S. Costs and healthcare utilisation due to respiratory syncytial virus disease in paediatric patients in Italy: a systematic review. Public Health 2024; 227:103-111. [PMID: 38154422 DOI: 10.1016/j.puhe.2023.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES Respiratory syncytial virus (RSV) is a frequent cause of acute lower respiratory infection in children, imposing a substantial economic burden on healthcare systems. This systematic review aimed to assess the economic burden and healthcare utilisation of RSV in children aged 0-59 months in Italy. STUDY DESIGN Systematic review. METHODS A systematic search of PubMed, Embase, Scopus, and the International HTA Database, including studies published in English or Italian, was conducted between January 2000 and July 2022. Inclusion criteria required studies to be conducted in Italy and provide data on the economic costs and healthcare resource utilisation related to RSV infections. RESULTS Out of 20,845 records screened, 18 articles met the inclusion criteria. Only one study provided comprehensive data on RSV disease costs, including hospitalisation, diagnostic tests, and medical procedures for infants with RSV-bronchiolitis. The mean cost per inpatient was higher for RSV-positive children (€5753.43 ± €2041.62) than that for RSV-negative children. Additionally, five studies reported a median length of hospital stay of 5 days for RSV-infected children, and four studies indicated a higher frequency of intensive care unit admissions for RSV-infected children than for those with other viral infections. CONCLUSIONS This is the first systematic review to examine the economic burden and healthcare utilisation of RSV in children aged 0-59 months in Italy. While limited data were available, the findings underscore the urgency to conduct further research and gather additional evidence on the costs and healthcare resource utilisation associated with RSV infections. Such efforts are essential for informing the development of effective prevention strategies for paediatric RSV infections in Italy.
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Affiliation(s)
- Angela Bechini
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Cristina Salvati
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Benedetta Bonito
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Marco Del Riccio
- Department of Health Sciences, University of Florence, Florence 50134, Italy.
| | - Enrica Stancanelli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Mario Bruschi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Giulia Ionita
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Johanna Alexandra Iamarino
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Davide Bentivegna
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Primo Buscemi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Giulia Ciardi
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Claudia Cosma
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Lorenzo Stacchini
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Cristiana Conticello
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Manjola Bega
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Sonia Paoli
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | - Annamaria Schirripa
- Medical Specialization School of Hygiene and Preventive Medicine, University of Florence, Florence 50134, Italy
| | | | | | | | | | | | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence 50134, Italy
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, Florence 50134, Italy
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Guo H, Song Y, Li H, Hu H, Shi Y, Jiang J, Guo J, Cao L, Mao N, Zhang Y. A Mixture of T-Cell Epitope Peptides Derived from Human Respiratory Syncytial Virus F Protein Conferred Protection in DR1-TCR Tg Mice. Vaccines (Basel) 2024; 12:77. [PMID: 38250890 PMCID: PMC10820450 DOI: 10.3390/vaccines12010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Human respiratory syncytial virus (HRSV) poses a significant disease burden on global health. To date, two vaccines that primarily induce humoral immunity to prevent HRSV infection have been approved, whereas vaccines that primarily induce T-cell immunity have not yet been well-represented. To address this gap, 25 predicted T-cell epitope peptides derived from the HRSV fusion protein with high human leukocyte antigen (HLA) binding potential were synthesized, and their ability to be recognized by PBMC from previously infected HRSV cases was assessed using an ELISpot assay. Finally, nine T-cell epitope peptides were selected, each of which was recognized by at least 20% of different donors' PBMC as potential vaccine candidates to prevent HRSV infection. The protective efficacy of F-9PV, a combination of nine peptides along with CpG-ODN and aluminum phosphate (Al) adjuvants, was validated in both HLA-humanized mice (DR1-TCR transgenic mice, Tg mice) and wild-type (WT) mice. The results show that F-9PV significantly enhanced protection against viral challenge as evidenced by reductions in viral load and pathological lesions in mice lungs. In addition, F-9PV elicits robust Th1-biased response, thereby mitigating the potential safety risk of Th2-induced respiratory disease during HRSV infection. Compared to WT mice, the F-9PV mice exhibited superior protection and immunogenicity in Tg mice, underscoring the specificity for human HLA. Overall, our results demonstrate that T-cell epitope peptides provide protection against HRSV infection in animal models even in the absence of neutralizing antibodies, indicating the feasibility of developing an HRSV T-cell epitope peptide-based vaccine.
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Affiliation(s)
- Hong Guo
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Yang Song
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Hai Li
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Hongqiao Hu
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Yuqing Shi
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Jie Jiang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Jinyuan Guo
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Lei Cao
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Naiying Mao
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
| | - Yan Zhang
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (H.G.); (Y.S.); (H.L.); (H.H.); (Y.S.); (J.J.); (J.G.); (L.C.)
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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