Title | Outcomes of human adenovirus infection and disease in a retrospective cohort of pediatric solid organ transplant recipients. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Boge CLK, Fisher BT, Petersen H, Seif AE, Purdy DR, Galetaki DM, Hodinka RL, Cárdenas AMaría, Kajon AE |
Journal | Pediatr Transplant |
Pagination | e13510 |
Date Published | 2019 Jun 18 |
ISSN | 1399-3046 |
Abstract | Information about HAdV infection in SOT recipients is limited. We aimed to describe HAdV infection epidemiology and outcomes in a single-center retrospective cohort during the era of PCR availability. SOT recipients transplanted at the CHOP 2004-2013 were followed up for 180 days post-transplant. HAdV infection was defined as a positive HAdV PCR from a clinical specimen. HAdV disease was defined by organ-specific radiologic and/or laboratory abnormalities. No HAdV surveillance protocols were employed during the study period; testing was solely per clinician discretion. Progression of HAdV infection was defined as HAdV disease or ≥1-log viral load increase since a corresponding site's first positive specimen. Of the assembled 425 SOT recipients, 227 (52.6%) had ≥1 HAdV PCR. Twenty-four (10.6%) had ≥1 HAdV-positive PCR. HAdV-positive subjects were younger than uninfected subjects (2.0 years vs 6.5, P = 0.001). Infection incidence rates were highest in liver recipients (15.3%), followed by heart (8.6%), kidney (8.3%), and lung (4.2%). Four subjects (16.7%) met HAdV disease criteria at virus detection. Five subjects (20.8%) had progression of HAdV infection. All-cause mortality rates in positive and negative subjects were 0% and 3.9%, respectively. HAdV infection was infrequently detected in SOT recipients. Over one-third of HAdV-positive patients met disease criteria at detection or had infection progression, but none died. This low all-cause mortality raises questions about benefits of HAdV surveillance. Larger multicenter studies are needed to assess incidence variance by center and comparative effectiveness of therapeutic interventions. |
DOI | 10.1111/petr.13510 |
Alternate Journal | Pediatr Transplant |
PubMed ID | 31210395 |
Grant List | HHSN2722011000040C / / Division of Intramural Research, National Institute of Allergy and Infectious Diseases / |