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Prolonged shedding of type 55 human adenovirus in immunocompetent adults with adenoviral respiratory infections

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Abstract

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.

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Abbreviations

CI:

Confidence interval

CVL:

Cumulative viral load

GMVL:

Geometric mean viral load

HAdV:

Human adenovirus

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Acknowledgments

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.

Funding

This work was supported by a grant from the Armed Forces Medical Command of the Republic of Korea [2016-KMMRP-012].

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Kyungmin Huh

  2. Biosewoom, Inc., Seoul, Republic of Korea

    Inseon Kim

  3. Armed Forces Medical Command, Seongnam, Republic of Korea

    Jaehun Jung

  4. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea

    Ji Eun Lee & Ho Jung Jeong

  5. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-ro 81, Gangnam-gu, Seoul, Republic of Korea

    Byung Woo Jhun & Hongseok Yoo

  6. Agency for Defense Development, Daejeon, Republic of Korea

    Se Hun Gu & Dong Hyun Song

  7. Department of Laboratory and Diagnostic Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea

    Eun Young Lee

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  1. Kyungmin Huh
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Corresponding author

Correspondence to Hongseok Yoo.

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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.

Ethical approval

This study was approved by the Institutional Review Board of the Armed Forces Medical Command (AFMC-16011-IRB-16-008).

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Written informed consents were obtained from all participating patients.

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Huh, K., Kim, I., Jung, J. et al. Prolonged shedding of type 55 human adenovirus in immunocompetent adults with adenoviral respiratory infections. Eur J Clin Microbiol Infect Dis 38, 793–800 (2019). https://doi.org/10.1007/s10096-019-03471-9

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  • DOI: https://doi.org/10.1007/s10096-019-03471-9

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