ABSTRACT
Background: Adenovirus [Ad] infections have delayed clearance in paediatric patients. The immune suppression that occurs after hematopoietic stem cell transplantation [HSCT] can reactivate adenovirus, resulting in life-threatening disseminated disease
Aim of the work: to assess adenovirus infection in recipients of bone marrow transplantation and to find out if there is an association between adenovirus infection and the occurrence of graft versus host disease [GVHD] in these patients
Patients and methods: The study was conducted on 30 pediatric patients admitted to Nasser institute, for bone marrow transplantation. Serum and stool samples were collected one day prior to bone marrow transplantation, and every one or two weeks afterwards till the patient completed 100 days after HSCT. The adenoviral DNA was monitored in the patient's serum and stool samples by quantitative real time polymerase chain reaction [qPCR]. The stool samples that tested positive for the presence of adenovirus were processed by cell culture technique for isolation of the virus
Results: Adenoviral DNA was detected in the fecal samples of 11 out of 30 patients [36.6% of cases]; the viral load ranged from 1.2 X 10[³] copies/gram, to 8.4 X 10[7] copies per gram, two patients had 2 positive stool samples with rising titer indicating the reactivation of the adenovirus. The adenoviral DNA was detected in the serum samples of only two patients [6.6% of cases], with a low titer, one of them was only 500 copies/ml and the other one was 1.6 X 10[4] copies /ml. The remaining serum samples of the patients who shed the adenovirus in their stool were all negative for adenoviral DNA. These two patients, who had Ad DNA in their serum, had no adenoviral shedding in their stool. The adenovirus reactivation was not associated with increased risk of developing GVHD, diarrhea or CMV reactivation
Conclusion: although the adenovirus was shed in the stool of 9 patients, the viral shedding was not associated with increased risk of developing GVHD, diarrhea or CMV reactivation