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John P. DeVincenzo, Caroline B. Hall, David W. Kimberlin, Pablo J. Sánchez, William J. Rodriguez, Barbara A. Jantausch, Lawrence Corey, Jeffrey S. Kahn, Janet A. Englund, JoAnn A. Suzich, Frances J. Palmer-Hill, Luis Branco, Syd Johnson, Nita K. Patel, Franco M. Piazza, Surveillance of Clinical Isolates of Respiratory Syncytial Virus for Palivizumab (Synagis)–Resistant Mutants, The Journal of Infectious Diseases, Volume 190, Issue 5, 1 September 2004, Pages 975–978, https://doi.org/10.1086/423213
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Abstract
Premature infants and those with chronic lung disease or congenital heart disease are at high risk of severe respiratory syncytial virus (RSV) disease. Palivizumab (Synagis), a humanized anti-RSV monoclonal antibody, has been used extensively since 1998 to prevent severe RSV disease in highrisk infants. To monitor for possible palivizumab-resistant mutants, an immunofluorescence binding assay that predicts palivizumab neutralization of RSV was developed. RSV isolates were collected at 8 US sites from 458 infants hospitalized for RSV disease (1998–2002). Palivizumab bound to all 371 RSV isolates able to be evaluated, including 25 from activepalivizumab recipients. The palivizumab epitope appears to be highly conserved, even in infants receiving prophylaxis with palivizumab.