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Persistence and reactivation of human adenoviruses in the gastrointestinal tract

K Kosulin1, E Geiger1, A Vécsei2

  • 1Children's Cancer Research Institute, Vienna, Austria.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|December 30, 2015
PubMed

Insights

Persistent human adenoviruses (HAdVs) in the pediatric gastrointestinal tract, particularly the terminal ileum, can lead to dangerous infections in immunocompromised children undergoing stem cell transplants.

Area of Science:

  • Virology
  • Immunology
  • Gastroenterology

Background:

  • Persistent human adenoviruses (HAdVs) pose significant risks, including high morbidity and mortality, in pediatric hematopoietic stem cell transplant (HSCT) recipients.
  • The gastrointestinal (GI) tract is a primary source of invasive HAdV infections, but the exact locations of HAdV persistence remain unclear.

Purpose of the Study:

  • To investigate the sites of HAdV persistence within the pediatric GI tract.
  • To determine the correlation between pre-transplant intestinal HAdV shedding and the risk of invasive infection post-transplant.

Main Methods:

  • Prospective screening of GI biopsies from 143 non-HSCT pediatric patients.
  • Monitoring of serial stool specimens from 148 pediatric HSCT recipients using real-time PCR.
  • In situ hybridization and immunohistochemistry to identify HAdV presence in specific GI tissues.

Main Results:

  • HAdV persistence in the GI tract was detected in 31% of pediatric patients, with the highest prevalence in the terminal ileum.
  • HAdV was identified in lymphoid cells of the lamina propria, indicating persistence in these cells.
  • High levels of replicating HAdV were found in intestinal epithelial cells of some transplant recipients.
  • Pre-transplant intestinal HAdV shedding correlated with an increased risk of invasive HAdV infection post-transplant.

Conclusions:

  • The pediatric GI tract serves as a reservoir for HAdV persistence and reactivation, particularly within intestinal lymphocytes.
  • The intestinal epithelium is a key site for viral replication preceding dissemination and invasive infections.
  • Findings are crucial for assessing the risk of life-threatening invasive HAdV infections in immunocompromised children.

Keywords:
Gastrointestinal tracthuman adenovirusintestinal lymphocytespersistencestem cell transplanted patients

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