Respiratory Syncytial Virus Immunoprophylaxis: Issues in Short-term and Longer-term Impact

* Abbreviations: CF — : cystic fibrosis LRTI — : lower respiratory tract infection RSV — : respiratory syncytial virus Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) in infants and young children, accounting for upwards of 130 000 hospitalizations per year in children <5 years of age in the United States.1 Globally, RSV is responsible for an estimated 3.4 million hospitalizations per year in children <5 years of age.2 Although all infants are at risk for severe RSV LRTI, increased risk has been demonstrated in preterm infants aged <6 months and those with other health conditions, such as chronic lung disease of prematurity and hemodynamically significant congenital heart disease. On the basis of the demonstration of decreased RSV hospitalizations in these groups in which the anti-RSV monoclonal antibody palivizumab was administered during RSV season compared with placebo,3,4 they have been the primary target for RSV immunoprophylaxis (IP) with palivizumab since its US Food and Drug Administration approval in 1998, although even 20 years after its licensure optimal indications for palivizumab … Address correspondence to Leonard R. Krilov, MD, Department of Pediatrics, Children’s Medical Center, NYU Winthrop Hospital, 259 First St, Mineola, NY 11501. E-mail: leonard.krilov{at}nyulangone.org