Possible Viral Interference Leading to Protection from Subsequent
Respiratory Viral Infections -- Results of an Observational Study at a
Singapore Teaching Hospital
Abstract
Background Viral interference is the concept that different viruses have
an effect on the incidence of other viruses– either positive or
negative. While this has been demonstrated in vitro and in animal
models, it is not well described in large observational studies. Methods
We analysed all patients tested for positive respiratory viruses between
January 2016– December 2019 just prior to the pandemic in the National
University Hospital laboratory, Singapore. Nasal, throat, and/ or
nasopharyngeal swabs were collected by treating clinicians and tested by
either multiplex PCR or immunofluorescence. Survival plots were created
to study the time for a second viral infection following the initial
respiratory viral detection. Results RSV (HR: 0.63, 95%CI: 0.43–0.92;
p<0.01) and influenza (HR: 0.41, 95%CI: 0.27-0.61;
p<0.001) -positive cases showed a greater delay in subsequent
respiratory infections compared to other pathogens, suggesting relative
protection, while enterovirus/ rhinovirus (HR: 2.05, 95%CI: 1.52-2.77;
p<0.001) and Parainfluenza (HR: 1.76, 95%CI: 1.18-2.63;
p<0.001) showed heightened susceptibility. No significant
associations were found for Adenovirus, seasonal coronaviruses, and
other pathogens. Conclusion We found that it is possible that prior
infections with Influenza virus or RSV conferred significant
cross-protection against subsequent circulating respiratory viral
infections for the next 4 years. Larger studies are needed to explore
mechanisms behind this possible broad-spectrum antiviral response in
human hosts as this may have implications for vaccination strategies.