Palavras-chave
Nirsevimabe
Palivizumabe
Pré-termos
Infecções do Trato Respiratório Inferior
Como Citar
Resumo
Introdução: o Vírus Sincicial Respiratório é a principal causa de infecções do trato respiratório inferior em lactentes, apresentando elevada morbidade em prematuros. A prevenção tradicional baseava-se no palivizumabe, porém, mudanças restritivas nas diretrizes da Academia Americana de Pediatria em 2014 e a recente introdução do nirsevimabe reconfiguraram o cenário profilático global. Objetivos: analisar o impacto das mudanças nas diretrizes de profilaxia do VSR e avaliar a eficácia, segurança e custo-efetividade dos novos anticorpos monoclonais, especificamente o nirsevimabe, na redução de hospitalizações e desfechos graves em prematuros. Metodologia: trata-se de uma revisão integrativa da literatura realizada nas bases de dados BVS e PubMed. A busca inicial recuperou 614 registros, dos quais, após rigoroso refinamento metodológico e remoção de duplicatas, foram selecionados 37 artigos para compor o corpus analítico final. Resultados e discussão: o cenário atual é marcado por elevadas taxas de hospitalização em prematuros tardios (29-34 semanas), fato que gera um paradoxo econômico devido ao alto custo dos cuidados intensivos. Em contrapartida, o nirsevimabe emerge como uma alternativa robusta, com eficácia superior a 80% na prevenção de internações em dose única. Somado a isso, análises de diferentes contextos sociodemográficos globais confirmam a efetividade da imunização universal, ao reduzir drasticamente a carga hospitalar e a necessidade de suporte ventilatório. Adicionalmente, análises de custo-efetividade indicam que a transição para estratégias universais é economicamente viável, especialmente ao mitigar custos operacionais de alta complexidade. Conclusão: A transição para estratégias de imunoprofilaxia universal com nirsevimabe e vacinação materna promete superar as limitações logísticas e o ônus epidemiológico da restrição ao palivizumabe, contudo, seu impacto real no Brasil depende da adaptação às sazonalidades locais, da mitigação de determinantes socioassistenciais e da integração efetiva entre os diferentes níveis de atenção à saúde.
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Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Copyright (c) 2026 Rayanne Reinaldo Moreira, Ana Laura Dias Azevedo, Emille Alves de Santana, Matheus Leite Mamedio Bahia, Tobias Pecorelli Gama Passos , Luciano de Oliveira Souza Tourinho (Autor)