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Adenovirus

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  • Authors: Michael G. Ison1, Randall T. Hayden2
  • Editors: Randall T. Hayden3, Donna M. Wolk4, Karen C. Carroll5, Yi-Wei Tang6
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Divisions of Infectious Diseases and Organ Transplantation, Transplant & Immunocompromised Host Infectious Diseases Service, Northwestern University Feinberg School of Medicine, Chicago, IL 60611; 2: Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN 38105; 3: St. Jude Children’s Research Hospital, Memphis, TN; 4: Geisinger Clinic, Danville, PA; 5: Johns Hopkins University Hospital, Baltimore, MD; 6: Memorial Sloane-Kettering Institute, New York, NY
  • Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015
  • Received 05 July 2015 Accepted 06 November 2015 Published 12 August 2016
  • Michael G. Ison, mgison@northwestern.edu
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  • Abstract:

    Adenoviruses are a highly prevalent infection that can cause a range of clinical syndromes in immunocompromised patients, ranging from localized disease of the respiratory tract, gastrointestinal tract, or urinary tract to disseminated disease. Adenovirus infections may develop in this unique population as the result of primary infection or reactivation of latent virus. Disease can be potentially progressive with high rates of mortality in patients with pneumonia and disseminated disease. Fortunately, cidofovir and its lipid ester, brincidofovir, appear to be effective for the treatment of adenovirus, although neither is specifically approved for this indication. Adenovirus should always be considered when immunocompromised patients present with any clinical syndrome that could be compatible with adenoviral infection. Once disease is suspected, cultures or molecular testing of appropriate specimens should be obtained and blood should be sent for adenovirus polymerase chain reaction (PCR) whenever adenovirus is suspected. Monitoring of quantitative viral loads in blood is helpful in predicting response to therapy with a significant drop (>1 log) associated with a higher probability of clinical response.

  • Citation: Ison M, Hayden R. 2016. Adenovirus. Microbiol Spectrum 4(4):DMIH2-0020-2015. doi:10.1128/microbiolspec.DMIH2-0020-2015.

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/content/journal/microbiolspec/10.1128/microbiolspec.DMIH2-0020-2015
2016-08-12
2017-11-20

Abstract:

Adenoviruses are a highly prevalent infection that can cause a range of clinical syndromes in immunocompromised patients, ranging from localized disease of the respiratory tract, gastrointestinal tract, or urinary tract to disseminated disease. Adenovirus infections may develop in this unique population as the result of primary infection or reactivation of latent virus. Disease can be potentially progressive with high rates of mortality in patients with pneumonia and disseminated disease. Fortunately, cidofovir and its lipid ester, brincidofovir, appear to be effective for the treatment of adenovirus, although neither is specifically approved for this indication. Adenovirus should always be considered when immunocompromised patients present with any clinical syndrome that could be compatible with adenoviral infection. Once disease is suspected, cultures or molecular testing of appropriate specimens should be obtained and blood should be sent for adenovirus polymerase chain reaction (PCR) whenever adenovirus is suspected. Monitoring of quantitative viral loads in blood is helpful in predicting response to therapy with a significant drop (>1 log) associated with a higher probability of clinical response.

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Figures

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FIGURE 1

Typical adenovirus cytopathic effect in hybrid cell lines composed of A549 and mink lung (Mv1Lu) cells. (Photograph courtesy of M. Bankowski)

Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015
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Image of FIGURE 2
FIGURE 2

Transmission electron microscopy of AdV 41 negatively stained with uranyl acetate. (Courtesy of Karin Boucke)

Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015
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FIGURE 3

Approach to diagnosis of suspected adenovirus disease ( 1 ).

Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015
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FIGURE 4

Approach to screening for adenovirus disease in pediatric stem-cell-transplant recipients ( 31 ). Adapted from Chakrabarti ( 14 ).

Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015
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Tables

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TABLE 1

Infections associated with adenovirus species and serotype

Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015
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TABLE 2

FDA-approved nucleic acid tests for adenovirus

Source: microbiolspec August 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0020-2015

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