Human Rhinoviruses (HRV) have been suggested to play a role in the development of childhood wheezing. However, whether HRV is causally related to the development of wheezing or HRV-associated wheeze is merely an indicator of disease susceptibility is unclear. Our aim was to study the role of HRV during infancy in the development of lower respiratory disease during infancy and childhood.

METHODS:: In a population-based birth-cohort, during the first year of life nose and throat swabs were collected on a monthly basis, regardless of any symptoms. Polymerase-chain-reaction was used to detect an extensive panel of respiratory pathogens. Lung function was measured before 2 months of age. Information on respiratory symptoms was collected by daily questionnaires and electronic patient files.

RESULTS:: 1.425 samples were collected in 140 infants. Both the presence of (single or multiple) pathogens (HRV equal to other pathogens), and increased respiratory system resistance, were significantly associated with lower respiratory symptoms during infancy. HRV-presence during infancy was not associated with the risk of wheezing at age 4, but every HRV-episode with wheezing increased the risk of wheezing at age 4 (OR 1.9, 1.1-3.5). This association weakened after adjustment for lung function (OR 1.4, 0.7-2.9).

CONCLUSIONS:: HRV and other viruses are associated with lower respiratory symptoms during infancy, as well as a high pre-symptomatic respiratory system resistance. HRV-presence during infancy is not associated with childhood wheezing, but wheeze during a HRV-episode is an indicator of children at high risk for childhood wheeze, partly because of a reduced neonatal lung function.