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Adenovirus: an increasingly important pathogen in paediatric bone marrow transplant patients
Tony Walls1, A G Shankar, Delane Shingadia
1Academic Department of Child Health, Royal London Hospital, Whitechapel, London, UK. t.m.walls@qmul.ac.uk
Insights
Adenovirus is a significant pathogen in children undergoing bone marrow transplantation, causing severe illness. Early detection and antiviral therapy are crucial for reducing mortality in these high-risk pediatric patients.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Hematology/Oncology
Background:
- Adenovirus is a growing concern in pediatric bone marrow transplant recipients.
- It causes severe disease in immunocompromised children, with high mortality rates for disseminated infections (up to 60%).
- Immune responses, particularly T-cell responses, are vital for recovery but not fully understood.
Purpose of the Study:
- To highlight the increasing recognition of adenovirus as a significant pathogen in pediatric bone marrow transplantation.
- To emphasize the need for early detection and effective treatment strategies.
- To discuss the potential impact of new diagnostic and therapeutic approaches.
Main Methods:
- Review of current understanding of adenovirus infections in immunocompromised children.
- Discussion of diagnostic advancements, including molecular techniques for early detection.
- Overview of treatment challenges and potential therapeutic strategies.
Main Results:
- Adenovirus infections commonly affect the gastrointestinal and urinary tracts.
- Disseminated infections carry a high mortality rate.
- Current treatments for immunocompromised patients have shown limited success.
Conclusions:
- Early detection of adenovirus through molecular diagnostics is now possible, often before symptom onset.
- Screening allows for prompt treatment initiation.
- Combined early detection and effective antiviral therapy offer hope for reducing deaths in high-risk children.
Abstract:
Adenovirus is increasingly being recognised as a significant pathogen in children following bone marrow transplantation. The virus is endemic in the general paediatric population, and frequently causes severe disease in immunocompromised patients, especially children. Immune responses to adenovirus infection are not fully understood but T-cell responses appear to be important for recovery. Infections can affect a variety of organs with gastrointestinal and urinary tract diseases being the most common. When disseminated infection occurs, reported mortality rates are as high as 60%. The responses to treatment in immunocompromised patients have generally been disappointing. New molecular diagnostic techniques have meant that adenoviral infections can now be detected early, often before symptoms have developed. Clinicians now screen for adenovirus infection to allow early initiation of treatment. It is hoped that this approach, together with effective antiviral therapy, will reduce the deaths from this common virus in high-risk children.