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Eur J Clin Microbiol Infect Dis. 2019 Apr;38(4):793-800. doi: 10.1007/s10096-019-03471-9. Epub 2019 Jan 29.

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

Author information

1
Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Biosewoom, Inc., Seoul, Republic of Korea.
3
Armed Forces Medical Command, Seongnam, Republic of Korea.
4
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea.
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.
6
Agency for Defense Development, Daejeon, Republic of Korea.
7
Department of Laboratory and Diagnostic Medicine, Armed Forces Capital Hospital, Seongnam, Republic of Korea.
8
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. hongseok.yoo@gmail.com.

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.

KEYWORDS:

Adenovirus; Pneumonia; Respiratory infections; Virus shedding

PMID:
30693422
DOI:
10.1007/s10096-019-03471-9
[Indexed for MEDLINE]

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