Association of Rhinovirus C Bronchiolitis and Immunoglobulin E Sensitization During Infancy With Development of Recurrent Wheeze

Importance Rhinovirusinfection in early life, particularly with allergic sensitization, is associated with higher risks of developing recurrent wheezeand asthma. While emerging evidence links different rhinovirusspecies (eg, rhinovirus C) to a higher severity of infection and asthma exacerbation, to our knowledge, little is known about longitudinal associations of rhinovirus Cinfection during infancy with subsequent morbidities. Objective To examine the association of different viruses (respiratory syncytial virus [RSV], rhinovirusspecies) in bronchiolitiswith risks of developing recurrent wheeze. Design, Setting, and Participants This multicenter prospective cohort study of infants younger than 1 year who were hospitalized for bronchiolitiswas conducted at 17 hospitals across 14 US states during 3 consecutive fall to winter seasons (2011-2014). Exposures Major causative viruses of bronchiolitis, including RSV (reference group) and 3 rhinovirusspecies ( rhinovirusA, B, and C). Main Outcomes and Measures Development of recurrent wheeze(as defined in national asthma guidelines) by age 3 years. Results This analytic cohort comprised 716 infants who were hospitalized for RSV-only or rhinovirus bronchiolitis. The median age was 2.9 months (interquartile range, 1.6-3.8 months), 541 (76%) had bronchiolitiswith RSV only, 85 (12%) had rhinovirusA, 12 (2%) had rhinovirusB, and 78 (11%) had rhinovirus Cinfection. Overall, 231 (32%) developed recurrent wheezeby age 3 years. In the multivariable Cox model, compared with infants with RSV-only infection, the risk of recurrent wheezewas not significantly different in those with rhinovirusA or B ( rhinovirusA: hazard ratio [HR], 1.27; 95% CI, 0.86-1.88; rhinovirusB: HR, 1.39; 95% CI, 0.51-3.77; both P  > .10). By contrast, infants with rhinovirus Chad a significantly higher risk (HR, 1.58; 95% CI, 1.08-2.32). There was a significant interaction between virus groups and IgE sensitization on the risk of recurrent wheeze( P for interaction Conclusions and Relevance This multicenter cohort study of infants hospitalized for bronchiolitisdemonstrated between-virus differences in the risk of developing recurrent wheeze. Infants with rhinovirus Cinfection, along with IgE sensitization, had the highest risk. This finding was driven by the association with a subtype of recurrent wheeze: children with subsequent development of asthma.