Les infections à adénovirus

Human adenoviruses are non enveloped DNA viruses, including around sixty serotypes divided into seven groups from A to G. The number of serotype grows due to recombination between different adenovirus from the same group. Adenoviruses typically cause upper or lower respiratory infection, gastroenteritis and conjunctivitis. Infections are most often banal in immunocompetent but they are more severe in immunocompromised patients where adenovirus can cause hepatitis, pancreatitis, hemorrhagic cystitis, and disseminated disease associated with a poor prognosis. The main methods are the direct antigen detection used for gastroenteritis, lower respiratory tract infections and conjunctivitis, and detection of the viral genome most commonly used for severe infection and for monitoring in immunocompromised patients. Serology has no clinical relevance and is only used in epidemiological studies. Only severe adenovirus infections are treated and cidofovir is the most widely drug used although its use remains controversial because randomized clinical trials have not been conducted yet. The CMX001 is a lipophilic analogue of cidofovir wich has better pharmacokinetic properties and few clinical observations have provided promising results. Adenoviruses are very resistant viruses in the environment and easily transmitted between individuals, it is imperative to reinforce strict measures of hygiene when positive patients are detected to limit any risk of nosocomial transmission.