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Title: The Role of Different Human Metapneumovirus (hMPV) Genotypes in Acute Respiratory Tract Infection and Disease in Kuwait Using Advanced Molecular Techniques
Authors: مريم بدران التراب 
Supervisor: أ.د. وداد النقيب
Keywords: Human Metapneumovirus Acute Respiratory Tract Infection Molecular Techniques
Issue Date: 2014
Publisher:  Kuwait university - college of graduate studies
Abstract: Human metapneumovirus (hMPV) is a respiratory pathogen that was discovered in 2001 in the Netherlands. Since its discovery it was recognized as an important cause of both upper and lower respiratory tract infections (RTIs), in all age groups and in all geographical areas. The role of hMPV in causing RTIs in Kuwait has not been investigated. Therefore, molecular methods for the hMPV detection among patients with RTIs, were developed and established for routine detection of this virus. Indeed, several molecular methods were used to accomplish this aim that included RT-PCR, in-house and commercial real-time RT-PCR for both hMPV detection and quantification, and in-house and commercial microarray assays for both hMPV detection and genotyping. In this study the frequency of hMPV infection in Kuwait in relation to other respiratory viruses, and its seasonal distribution were investigated. Furthermore, the prevalence of different hMPV genotypes circulating in this area were determined by direct sequencing, and the potential correlation between different hMPV genotypes and the severity of respiratory tract disease was analyzed. In addition, the association between RNA load of different hMPV genotypes and its effect on the outcome and prognosis of hMPV disease was also investigated. Our results shows that the prevalence of hMPV infection in Kuwait among patients with RTIs was almost 5%, both genotypes A and B were detected in Kuwait with no predominance of one over the other. Furthermore, there was no evidence for direct correlation between hMPV genotypes and the severity of the clinical outcome. Moreover, hMPV infection was seasonal, and peaks occurred during winter and spring. HMPV infection was detected in all age groups, but mostly in young children and the elderly. Most of hMPV positive patients presented with lower RTIs such as pneumonia and bronchopneumonia. The major cause of lower RTIs in our study population was human rhinovirus (hRV) (30%), followed by hMPV (22%), and then human respiratory syncytial virus (hRSV) (13%). The proportion of hMPV co-infection with other respiratory viruses was almost 19% among hMPV-positive cases (mainly hRV 13%). This co-infection was associated with more severe disease and prolonged hospital stay. High viral RNA load in hMPV positive patients with lower RTIs correlated well with the severity of clinical symptoms and virus replication rate. Our results highlights the importance of hMPV infection as an important cause of severe LRTI, especially among children and elderly in Kuwait.
Appears in Programs:0520 Microbiology (Ph.D.)

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