Prolonged shedding of type 55 human adenovirus in immunocompetent adults with adenoviral respiratory infections
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Human adenovirus (HAdV) is a common pathogen causing respiratory infections with outbreaks reported in the military and community. However, little information is available on the shedding kinetics. We performed a prospective study of immunocompetent adults confirmed with HAdV respiratory infection by multiplex real-time PCR during an outbreak of HAdV-55. Consecutive respiratory specimens of sputum or nasopharyngeal swab were collected from each patient every 2 days. Viral load was measured by real-time quantitative PCR. Of 32 enrolled patients, 27 (84.4%) had pneumonia. Five patients (15.6%) received cidofovir. Viral load was highest in the earliest samples at 8.69 log10 copies/mL. In a linear regression model, viral load declined consistently in a log-linear fashion at the rate of − 0.15 log10 copies/mL per day (95% confidence interval (CI): − 0.18, − 0.12; R2 = 0.32). However, the regression model estimated the viral shedding duration to be 55 days. The rate of decline in viral load did not differ between patients who received cidofovir and who did not. Patients with prominent respiratory symptoms or extensive involvement on chest radiograph had higher volume of viral excretion. Prolonged viral shedding was observed in otherwise healthy adults with HAdV-55 respiratory infection. This finding should be considered in the establishment of infection control and prevention strategies.
KeywordsAdenovirus Pneumonia Respiratory infections Virus shedding
Cumulative viral load
Geometric mean viral load
Authors wish to express our sincere gratitude to the nurses who contributed to the collection of respiratory specimens, and to the patients who chose to participate in our study. Also, we thank Professor Yae-Jean Kim for the critical reading of our manuscript.
This work was supported by a grant from the Armed Forces Medical Command of the Republic of Korea [2016-KMMRP-012].
Compliance with ethical standards
Conflict of interest
I.K is an employee for Biosewoom, Inc., which is a manufacturer and distributor of a commercial diagnostic kit using multiplex PCR for respiratory virus used in this study. All other authors have nothing to declare.
This study was approved by the Institutional Review Board of the Armed Forces Medical Command (AFMC-16011-IRB-16-008).
Written informed consents were obtained from all participating patients.
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