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J Clin Virol. 2014 Dec;61(4):496-502. doi: 10.1016/j.jcv.2014.09.009. Epub 2014 Sep 28.

Identification of a novel intertypic recombinant species D human adenovirus in a pediatric stem cell transplant recipient.

Author information

1
Infectious Disease Program, Lovelace Respiratory Research Institute, Albuquerque, NM, USA. Electronic address: akajon@lrri.org.
2
Virology Laboratory, Wadsworth Center, New York State Department of Health, Albany, NY, USA.
3
Applied Genomics Technologies Core, Wadsworth Center, New York State Department of Health, Albany, NY, USA.
4
Division of Infectious Diseases, and The Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
5
Department of Pathology and Laboratory Medicine and Clinical Virology Laboratory, Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

Abstract

BACKGROUND:

Human adenoviruses (HAdV) are known opportunistic pathogens in hematopoietic stem cell transplant (SCT) recipients. The detection of HAdV infection in children after SCT has been implicated as a determinant of poor outcome but specific associations between HAdV species or individual HAdV types and disease are poorly understood.

OBJECTIVES:

Characterization of a HAdV-D strain isolated from multiple clinical specimens of an 11-year-old female recipient of a matched unrelated donor peripheral SCT for T-cell lymphoma and case report.

STUDY DESIGN:

Archived HAdV PCR-positive plasma, urine, and stool specimens were processed for virus isolation and detailed molecular typing. Complete genomic sequencing was carried out on 2 isolates.

RESULTS:

The patient tested positive for HAdV DNA by real-time PCR of a stool specimen at 44 days after initiation of a SCT conditioning regimen. In the subsequent 3 months, HAdV was detected in plasma, urine and stool specimens in association with symptoms of gastroenteritis and hemorrhagic cystitis. A novel HAdV-D with a HAdV20-like hexon gene was isolated from both urine and stool specimens. All isolates yielded identical restriction profiles with endonucleases BamHI, BglII, BstEII, HindIII, PstI and SmaI. Analysis of 2 complete genomic sequences further identified the virus as a novel intertypic recombinant HAdV-D (P20/H20/F42) closely related to HAdV42.

CONCLUSIONS:

This case highlights the identification of a previously unknown HAdV-D from an immunocompromised host. In this patient, the course of adenovirus infection is compatible with reactivation of a latent virus or a primary opportunistic infection. Adenoviremia in this patient resolved without definitive adenovirus-directed antiviral therapy.

KEYWORDS:

Adenovirus; Genomic sequence; Species D; Transplant

PMID:
25449172
PMCID:
PMC4276453
DOI:
10.1016/j.jcv.2014.09.009
[Indexed for MEDLINE]
Free PMC Article

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