| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3369596 | Journal of Clinical Virology | 2011 | 5 Pages |
BackgroundHuman adenoviruses (HAdV) can cause disseminated disease as a severe complication after haematopoietic stem cell transplantation (SCT) and may originate from the reactivation of latent infections. However, data about the clinical relevance of HAdV DNAaemia and disease in adults are scarce.ObjectivesTo retrospectively analyse the outcome of adult allogeneic SCT recipients with high HAdV loads in peripheral blood.Study designOur diagnostic database was screened for allogeneic SCT recipients with peak HAdV DNAaemia above 1.0 × 104 copies/ml (tested by quantitative real-time PCR) and medical records were reviewed retrospectively.ResultsFrom 1674 adult allogeneic SCT recipients 539 (32.2%) received HAdV DNAaemia testing. In twenty-seven of these HAdV blood loads above 1.0 × 104 (range: 1.6 × 104–1.8 × 109) copies/ml were observed. Seven of these 27 succumbed to HAdV disease and their median peak HAdV DNAaemia was significantly higher than in patients without HAdV-associated death (1.0 × 108 vs. 3 × 105 copies/ml, p < 0.001). T-cell depletion was a risk factor for fatal HAdV disease. HAdV of species C predominated (66.7%) and were of high virulence (6 of 7 fatal cases). HAdV of species B were observed more frequently (n = 6) in our study than reported for paediatrics, indicating a different pattern of HAdV reactivation in adults.ConclusionsThe presence of several HAdV-associated deaths in adult SCT recipients with high-level HAdV DNAaemia confirmed the clinical relevance of HAdV DNAaemia testing in adults. Quantitative HAdV DNAaemia testing is a promising tool to predict the outcome of HAdV disease.
