Quantification of adenovirus DNA in unrelated donor hematopoietic stem cell transplant recipients.
BACKGROUND
Adenovirus (AdV) infection is a life threatening condition in immunosuppressed patients. Quantitative AdV assays can improve the clinical management of these patients.


OBJECTIVE
To evaluate quantitative measurement of AdV DNA with PCR in blood from hematopoietic stem cell transplant (HSCT) recipients.


METHODS
Quantitative PCR was used to measure viral DNA levels of AdV in consecutive blood samples from 40 HSCT recipients (27 adults and 13 children) during a 1-year post-engraftment period. All patients received grafts from unrelated donors and were given anti-T-cell antibodies in the conditioning regimen.


RESULTS
In the group of 40 patients, six (15%) had detectable AdV DNA in blood for different lengths of time. None of these six patients suffered from severe graft-versus-host disease. In three of the patients a high AdV viral load (>10,000 copies/mL) was detected, one of whom also had high viral load of EBV and CMV and one of EBV only. These three patients died within 2 months after detection of ADV viremia. A low AdV viral load (<500 copies/mL) was detected in three surviving patients and they did not have concomitant high viral load of neither CMV nor EBV.


CONCLUSIONS
AdV viremia was present in 15% of the HSCT recipients and a high AdV viral load was associated with fatal outcome. Screening for AdV DNA with quantitative PCR in blood may be of clinical importance in allogeneic HSCT recipients in order to prevent severe clinical virological complications.
Department of Medicine, Infectious Disease Unit, B2:00, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, S-171 76 Stockholm, Sweden.
I
I
Gustafson
A
A
Lindblom
Z
Z
Yun
H
H
Omar
L
L
Engstrom
I
I
Lewensohn-Fuchs
P
P
Ljungman
K
K
Broliden
D000258:Adenovirus Infections, Human / Q000821:virology*; D000260:Adenoviruses, Human / Q000302:isolation & purification*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000302:isolation & purification; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D019562:Viral Load
D004279:DNA, Viral