Abstract
Adenovirus infections are increasing as causes of morbidity and mortality in severely immunocompromised patients. The currently available antiviral agents, ribavirin and cidofovir, have yielded mixed results in case reports and small case series. Similar to cytomegalovirus disease, established adenovirus disease is often difficult to treat. Therapy may yield poor results, even when effective antiviral drugs are used. New strategies, including pre-emptive therapy, should be tested in prospective, clinical trials. New agents and adoptive transfer of specific T-cells to adenovirus might improve the current situation.
Similar content being viewed by others
References
Cooper RJ, Hallett R, Tullo AB, Klapper PE (2000) The epidemiology of adenovirus infections in greater Manchester, UK 1982–96. Epidemiol Infect 125:333–345
Singh-Naz N, Brown M, Ganeshananthan M (1993) Nosocomial adenovirus infection: molecular epidemiology of an outbreak. Pediatr Infect Dis J 12:922–925
Venard V, Carret A, Corsaro D, Bordigoni P, Le Faou A (2000) Genotyping of adenoviruses isolated in an outbreak in a bone marrow transplant unit shows that diverse strains are involved. J Hosp Infect 44:71–74
Runde V, Ross S, Trenschel R, Lagemann E, Basu O, Renzing-Kohler K, Schaefer UW, Roggendorf M, Holler E (2001) Adenoviral infection after allogeneic stem cell transplantation (SCT): report on 130 patients from a single SCT unit involved in a prospective multi center surveillance study. Bone Marrow Transplant 28:51–57
Shields AF, Hackman RC, Fife KH, Corey L, Meyers JD (1985) Adenovirus infections in patients undergoing bone-marrow transplantation. N Engl J Med 312:529–533
Bruno B, Gooley T, Hackman RC, Davis C, Corey L, Boeckh M (2003) Adenovirus infection in hematopoietic stem cell transplantation: effect of ganciclovir and impact on survival. Biol Blood Marrow Transplant 9:341–352
Flomenberg P, Babbitt J, Drobyski WR, Ash RC, Carrigan DR, Sedmak GV, McAuliffe T, Camitta B, Horowitz MM, Bunin N, Casper JT (1994) Increasing incidence of adenovirus disease in bone marrow transplant recipients. J Infect Dis 169:775–781
Lion T, Baumgartinger R, Watzinger F, Matthes-Martin S, Suda M, Preuner S, Futterknecht B, Lawitschka A, Peters C, Potschger U, Gadner H (2003) Molecular monitoring of adenovirus in peripheral blood after allogeneic bone marrow transplantation permits early diagnosis of disseminated disease. Blood 102:1114–1120
Hoffman JA, Shah AJ, Ross LA, Kapoor N (2001) Adenoviral infections and a prospective trial of cidofovir in pediatric hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 7:388–394
Howard DS, Phillips IG, Reece DE, Munn RK, Henslee-Downey J, Pittard M, Barker M, Pomeroy C (1999). Adenovirus infections in hematopoietic stem cell transplant recipients. Clin Infect Dis 29:1494–1501
La Rosa AM, Champlin RE, Mirza N, Gajewski J, Giralt S, Rolston KV, Raad I, Jacobson K, Kontoyiannis D, Elting L, Whimbey E (2001) Adenovirus infections in adult recipients of blood and marrow transplants. Clin Infect Dis 32:871–876
Baldwin A, Kingman H, Darville M, Foot AB, Grier D, Cornish JM, Goulden N, Oakhill A, Pamphilon DH, Steward CG, Marks DI (2000) Outcome and clinical course of 100 patients with adenovirus infection following bone marrow transplantation. Bone Marrow Transplant 26:1333–1338
Hale GA, Heslop HE, Krance RA, Brenner MA, Jayawardene D, Srivastava DK, Patrick CC (1999) Adenovirus infection after pediatric bone marrow transplantation. Bone Marrow Transplant 23:277–282
Chakrabarti S, Mautner V, Osman H, Collingham KE, Fegan CD, Klapper PE, Moss PA, Milligan DW (2002) Adenovirus infections following allogeneic stem cell transplantation: incidence and outcome in relation to graft manipulation, immunosuppression, and immune recovery. Blood 100:1619–1627
Michaels MG, Green M, Wald ER, Starzl TE (1992) Adenovirus infection in pediatric liver transplant recipients. J Infect Dis 165:170–174
McGrath D, Falagas ME, Freeman R, Rohrer R, Fairchild R, Colbach C, Snydman DR (1998) Adenovirus infection in adult orthotopic liver transplant recipients: incidence and clinical significance. J Infect Dis 177:459–462
Meyers JD, Ljungman P, Fisher LD (1990) Cytomegalovirus excretion as a predictor of cytomegalovirus disease after marrow transplantation: importance of cytomegalovirus viremia. J Infect Dis 162:373–380
Keller EW, Rubin RH, Black PH, Hirsch MS, Hierholzer JC (1977) Isolation of adenovirus type 34 from a renal transplant recipient with interstitial pneumonia. Transplantation 23:188–191
Stalder H, Hierholzer JC, Oxman MN (1977) New human adenovirus (candidate adenovirus type 35) causing fatal disseminated infection in a renal transplant recipient. J Clin Microbiol 6:257–265
Ohori NP, Michaels MG, Jaffe R, Williams P, Yousem SA (1995) Adenovirus pneumonia in lung transplant recipients. Hum Pathol 26:1073–1079
Bridges ND, Spray TL, Collins MH, Bowles NE, Towbin JA (1998) Adenovirus infection in the lung results in graft failure after lung transplantation. J Thorac Cardiovasc Surg 116:617–623
Cavalli-Bjorkman N, Osby E, Lundin J, Kalin M, Osterborg A, Gruber A (2002) Fatal adenovirus infection during alemtuzumab (anti-CD52 monoclonal antibody) treatment of a patient with fludarabine-refractory B-cell chronic lymphocytic leukemia. Med Oncol 19:277–280
Ljungman P, Ehrnst A, Björkstrand B, Hellström E, Ingelman SH, Juliusson G, Lönnqvist B (1990) Lethal disseminated adenovirus type 1 infection in a patient with chronic lymphocytic leukemia. Scand J Infect Dis 22:601–605
Kaur B, Gottardo NG, Keil AD, Hallam LA, Baker DL (2002) A rare case of adenoviral fulminant hepatic necrosis after chemotherapy. Pediatr Hematol Oncol 19:361–371
Bordigoni P, Carret AS, Venard V, Witz F, Le Faou A (2001) Treatment of adenovirus infections in patients undergoing allogeneic hematopoietic stem cell transplantation. Clin Infect Dis 32:1290–1297
Miyamura K, Hamaguchi M, Taji H, Kanie T, Kohno A, Tanimoto M, Saito H, Kojima S, Matsuyama T, Kitaori K, Nagafuji K, Sato T, Kodera Y (2000) Successful ribavirin therapy for severe adenovirus hemorrhagic cystitis after allogeneic marrow transplant from close HLA donors rather than distant donors. Bone Marrow Transplant 25:545–548
Arav-Boger R, Echavarria M, Forman M, Charache P, Persaud D (2000) Clearance of adenoviral hepatitis with ribavirin therapy in a pediatric liver transplant recipient. Pediatr Infect Dis J 19:1097–1100
Gavin PJ, Katz BZ (2002) Intravenous ribavirin treatment for severe adenovirus disease in immunocompromised children. Pediatrics 110:e9
Samarasinghe S, Cubitt D, Veys P (2002) Adenovirus infections during bone marrow transplantation. Royal College of Paediatrics and Child Health Sixth Spring Meeting, York, UK
Morfin F, Dupuis-Girod S, Carrington D, Sedlacek P, Bierings M, Cetkovsky P, van Tol M, Thouvenot D. Adenovirus susceptibility to antiviral group is genotype-dependent. In: Program and abstracts. 43rd interscience conference on antimicrobial agents and chemotherapy, abstract no. 488
Ljungman P, Ribaud P, Eyrich M, Matthes-Martin S, Einsele H, Bleakley M, Machaczka M, Bierings M, Bosi A, Gratecos N, Cordonnier C (2003) Cidofovir for adenovirus infections after allogeneic hematopoietic stem cell transplantation: a survey by the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 31:481–486
Legrand F, Berrebi D, Houhou N, Freymuth F, Faye A, Duval M, Mougenot JF, Peuchmaur M, Vilmer E (2001) Early diagnosis of adenovirus infection and treatment with cidofovir after bone marrow transplantation in children. Bone Marrow Transplant 27:621–626
Lion T, Matthes-Martin S, Suda M, Preuner S, Watzinger F, Lawitschka A, Peters C, Gadner H (2003) Intestinal adenovirus infection with increasing viral load in stool is an early indicator of impending disseminated disease in children undergoing T-cell depleted allogeneic stem cell transplantation. Blood 102:196a
Hamel Y, Blake N, Gabrielsson S, Haigh T, Jooss K, Martinache C, Caillat-Zucman S, Rickinson AB, Hacein-Bey S, Fischer A, Cavazzana-Calvo M (2002) Adenovirally transduced dendritic cells induce bispecific cytotoxic T lymphocyte responses against adenovirus and cytomegalovirus pp65 or against adenovirus and Epstein-Barr virus EBNA3C protein: a novel approach for immunotherapy. Hum Gene Ther 13:855–866
Acknowledgement
This study was supported by the Swedish Children’s Cancer Fund.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ljungman, P. Treatment of adenovirus infections in the immunocompromised host. Eur J Clin Microbiol Infect Dis 23, 583–588 (2004). https://doi.org/10.1007/s10096-004-1165-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-004-1165-x