Adenoviruses

Abstract

Adenoviruses (AdVs) are non‐enveloped DNA viruses that can cause a wide range of clinical manifestations including respiratory, gastrointestinal and ocular, as well as hepatic, renal and disseminated diseases. Outcomes can range from mild and self‐limited to severe life‐threatening conditions and death. Higher morbidity and mortality is observed with certain AdVs serotypes and among immunocompromised patients. AdVs are capable of evading the immune response and they can produce persistent or latent infections. Therefore, reactivation can occur during immunosuppression. Conventional and molecular methods are used for diagnosis, although the last ones are more sensitive and can be used for quantification. Antivirals, such as ribavirin and cido‐fovir, are used in some patients, especially stem cell transplant recipients. AdV vaccine against serotypes 4 and 7 is available for US military recruits. Early diagnosis of AdVs infections is critical for patient management and infection control measurements.

Key Concepts

  • Adenoviruses can cause a variety of clinical manifestations because of high number of serotypes and their wide cell tropism.

  • The implementation of molecular methods for adenovirus diagnosis has increased their awareness in the clinical setting as severe and emerging pathogens.

  • AdV serotypes are defined by neutralisation and haemagglutination assays using specific antisera.

  • Adenoviruses are very stable and highly resistant to inactivation at room temperature.

  • Adenovirus species C can establish a latent infection in lymphocytes of the tonsils and adenoid tissue.

  • Clinical manifestations depend on the host and the serotypes involved and can affect the respiratory, gastrointestinal or ocular tract and the liver, kidney or nervous central system.

  • Severe infections and fatal cases are more frequent in immunocompromised patients such as stem cell transplant recipients.

  • Adenovirus diagnosis in blood requires the use of molecular methods.

  • An oral attenuated live adenovirus vaccine against serotypes 4 and 7 is available for US militaries to prevent respiratory disease.

Keywords: adenovirus; disease; diagnosis; pathogenesis; replication; latency; respiratory infections; PCR; serotypes; transplant patients

Figure 1. Adenovirus structure.
Figure 2. Electronic microscopy micrograph of adenovirus in a thin section of the infected cell (magnification ×108.000). Photo by Dr. Ludmila Asher, WRAIR. Reproduced with permission from Echavarría, M. (2009) Adenoviruses © John Wiley & Sons.
Figure 3. Medical care professional with keratoconjuntivitis during a nosocomial outbreak.
Figure 4. Immunoperoxidase staining for adenoviruses in a liver biopsy from a liver transplant patient.
Figure 5. Molecular detection methods for adenovirus. (a) PCR products 2% agarose gel. M = marker; 1, 2, 3, 4 = serial dilutions of AdV2; 5 = negative control. (b) Southern blot from agarose gel. 1, 2, 3, 4 = serial dilutions of AdV2; 5 = negative control. (c) Real‐time PCR amplification curves in semi‐logarithmic view. Follow‐up of a patient with acute respiratory infection on subsequent dates.
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Further Reading

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San Martin C (2012) Latest insights on adenovirus structure and assembly. Viruses 4: 847–877.

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Echavarría, Marcela(Jan 2015) Adenoviruses. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0000409.pub2]