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Observational Study
. 2019 Sep;23(6):e13510.
doi: 10.1111/petr.13510. Epub 2019 Jun 18.

Outcomes of human adenovirus infection and disease in a retrospective cohort of pediatric solid organ transplant recipients

Craig L K Boge  1   2 , Brian T Fisher  1   2   3   4 , Hans Petersen  5 , Alix E Seif  3   6 , Dale R Purdy  2 , Despoina M Galetaki  1   2 , Richard L Hodinka  7 , Ana María Cárdenas  8   9 , Adriana E Kajon  5
Affiliations
Observational Study

Outcomes of human adenovirus infection and disease in a retrospective cohort of pediatric solid organ transplant recipients

Craig L K Boge et al. Pediatr Transplant. 2019 Sep.

Abstract

Information about HAdV infection in SOT recipients is limited. We aimed to describe HAdV infection epidemiology and outcomes in a single-center retrospective cohort during the era of PCR availability. SOT recipients transplanted at the CHOP 2004-2013 were followed up for 180 days post-transplant. HAdV infection was defined as a positive HAdV PCR from a clinical specimen. HAdV disease was defined by organ-specific radiologic and/or laboratory abnormalities. No HAdV surveillance protocols were employed during the study period; testing was solely per clinician discretion. Progression of HAdV infection was defined as HAdV disease or ≥1-log viral load increase since a corresponding site's first positive specimen. Of the assembled 425 SOT recipients, 227 (52.6%) had ≥1 HAdV PCR. Twenty-four (10.6%) had ≥1 HAdV-positive PCR. HAdV-positive subjects were younger than uninfected subjects (2.0 years vs 6.5, P = 0.001). Infection incidence rates were highest in liver recipients (15.3%), followed by heart (8.6%), kidney (8.3%), and lung (4.2%). Four subjects (16.7%) met HAdV disease criteria at virus detection. Five subjects (20.8%) had progression of HAdV infection. All-cause mortality rates in positive and negative subjects were 0% and 3.9%, respectively. HAdV infection was infrequently detected in SOT recipients. Over one-third of HAdV-positive patients met disease criteria at detection or had infection progression, but none died. This low all-cause mortality raises questions about benefits of HAdV surveillance. Larger multicenter studies are needed to assess incidence variance by center and comparative effectiveness of therapeutic interventions.

Keywords: adenoviruses; human; organ transplantation; pediatrics.

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Conflict of interest statement

Potential Conflicts of interest: B.T.F. receives research support that goes directly to his institution from Pfizer and Merck.

Figures

Figure
Figure
Running Count of Subjects Testing Positive for Human Adenovirus for Each Day of Follow-up, by Primary Transplanted Organ.
See this image and copyright information in PMC

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