Adenovirus: Epidemiology, Global Spread of Novel Types, and Approach to Treatment

Abstract

Adenoviruses (AdVs) are DNA viruses that typically cause mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva. Rare manifestations of AdV infections include hemorrhagic cystitis, hepatitis, hemorrhagic colitis, pancreatitis, nephritis, or meningoencephalitis. AdV infections are more common in young children, due to lack of humoral immunity. Epidemics of AdV infection may occur in healthy children or adults in closed or crowded settings (particularly military recruits). The vast majority of cases are self-limited. However, the clinical spectrum is broad and fatalities may occur. Dissemination is more likely in patients with impaired immunity (e.g., organ transplant recipients, human immunodeficiency virus infection). Fatality rates for untreated severe AdV pneumonia or disseminated disease may exceed 50%. More than 100 genotypes and 52 serotypes of AdV have been identified and classified into seven species designated HAdV-A through -G. Different types display different tissue tropisms that correlate with clinical manifestations of infection. The predominant types circulating at a given time differ among countries or regions, and change over time. Transmission of novel strains between countries or across continents and replacement of dominant viruses by new strains may occur. Treatment of AdV infections is controversial, as prospective, randomized therapeutic trials have not been done. Cidofovir has been the drug of choice for severe AdV infections, but not all patients require treatment. Live oral vaccines are highly efficacious in reducing the risk of respiratory AdV infection and are in routine use in the military in the United States but currently are not available to civilians.

Study on the Anti-Adenovirus Mechanism of Sargassum fusiforme

“…There are no specific drugs or vaccines available to control HAdV infection; the focus of clinical treatments of adenovirus infections is mostly to reduce the symptoms of patients ( Liu et al., 2018 ; Tian et al., 2018 ). However, inadequate efficacy and numerous adverse reactions have been observed with such treatments in many cases ( Lynch and Kajon, 2021 ). Consequently, discovering new and effective anti-HAdV agents is particularly urgent.…”

Acute, Severe Hepatitis of Unknown Origin: Should We Really Be Afraid of Another Obscure Enemy of Our Children?

“…Adenovirus type 41, the apparently implicated adenovirus type, typically presents as diarrhea, vomiting, and fever, often accompanied by respiratory symptoms. While there have been case reports of hepatitis in immunocompromised children with adenovirus infection, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children [ 3 , 4 ].…”

Soluble Receptor for Advanced Glycation End Product Is Involved in the Inflammatory Response of Human Adenovirus-Infected Patients

“…Human adenoviruses (HAdVs) belong to the genus Mastadenovirus of the family Adenoviridae. About 100 distinct genotypes have been identified to date, and these genotypes can be divided into 7 species (A–G) ( Lynch and Kajon, 2021 ). HAdV infection typically causes asymptomatic to mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva, and most cases are self-limited.…”

“…HAdV infection typically causes asymptomatic to mild infections involving the upper or lower respiratory tract, gastrointestinal tract, or conjunctiva, and most cases are self-limited. However, HAdV can cause severe/fatal pneumonia in both immunocompetent and immunocompromised individuals ( Lynch and Kajon, 2021 ). Kindergarten children, students, and military recruits are very vulnerable to HAdV infection ( Lynch and Kajon, 2021 ).…”

“…However, HAdV can cause severe/fatal pneumonia in both immunocompetent and immunocompromised individuals ( Lynch and Kajon, 2021 ). Kindergarten children, students, and military recruits are very vulnerable to HAdV infection ( Lynch and Kajon, 2021 ). In immunocompromised patients, especially in patients undergoing transplantation, HAdV may cause severe symptoms, such as hepatitis, nephritis, meningoencephalitis, and pneumonia, and can have a mortality rate of up to 70%, especially in pediatric patients undergoing stem cell transplantation ( Lion, 2014 ).…”