title: Poor outcome of adenovirus infections in adult hematopoietic stem cell transplant patients with sustained adenovirus viremia.
abstract: The outcome of adenovirus (ADV) infections in adult hematopoietic stem cell transplant (HSCT) patients remains poorly characterized. We studied 14 adults and 3 children, who had undergone HSCT and had developed ADV viremia. Peak ADV DNA levels were significantly higher in patients with ADV diseases than in those without (P=0.03). All children survived the ADV infections. Among the 14 adult HSCT patients, 11 were treated with cidofovir, 2 with ribavirin, and 1 did not receive antiviral treatment. Six of the 13 (46%) treated patients developed ADV diseases and 3 of them (23%) died of ADV infections. Sustained viremia (≥3 positive polymerase chain reaction assays during follow-up) was detected in all patients who finally died of ADV infections. However, 2 adults having had transient ADV viremia either survived or died of diseases other than ADV infections. Our study indicates that the outcome of adult HSCT patients with sustained ADV viremia may be poor, even for those who have received anti-ADV treatment.
authors.affiliation: Department of Medicine, Division of Hematology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Omar
authors.forename: Z
authors.initials: Z
authors.lastname: Yun
authors.forename: I
authors.initials: I
authors.lastname: Lewensohn-Fuchs
authors.forename: L
authors.initials: L
authors.lastname: Pérez-Bercoff
authors.forename: C
authors.initials: C
authors.lastname: Orvell
authors.forename: L
authors.initials: L
authors.lastname: Engström
authors.forename: G-K
authors.initials: GK
authors.lastname: Vuong
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
mesh_terms: D000257:Adenoviridae Infections / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D058345:Asymptomatic Infections; D002648:Child; D002675:Child, Preschool; D000077404:Cidofovir; D015331:Cohort Studies; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D012254:Ribavirin; D003596:Cytosine; D000077404:Cidofovir