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Whole-Genome Sequencing of Adenovirus Genotypes and Clinical Implications in Pediatric Patients
Lorena Forqué1, Valeria Fox1, Rossana Scutari1
1Multimodal Laboratory Medicine, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Insights
Human adenoviruses (HAdV) show varied species distribution in children based on immune status. Species F is common in immunocompetent children, while species C and A are prevalent in immunocompromised children.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Human adenoviruses (HAdV) encompass over 100 genotypes with distinct tropism and immune responses.
- HAdV infections can lead to severe outcomes, particularly in immunocompromised individuals.
Purpose of the Study:
- To characterize HAdV species in pediatric infections.
- To assess the clinical impact of different HAdV species.
- To guide development of AdV-specific T-cell therapies.
Main Methods:
- Retrospective analysis of 595 pediatric HAdV diagnoses (Jan-Oct 2024).
- Whole-genome sequencing of 60 HAdV samples.
- Clinical data review including immune status and symptoms.
Main Results:
- Species F (F41) was most prevalent (63.3%), particularly in immunocompetent children.
- Species C and A predominated in immunocompromised children; Species A linked to severe disease.
- Higher viral loads observed for Species F compared to A and C, irrespective of immune status.
- Co-infections were frequent (63.3%), with Species C associated with co-infections.
Conclusions:
- HAdV species distribution in children is influenced by immune status.
- Whole-genome sequencing aids surveillance, diagnosis, and development of targeted immunotherapies.
Abstract:
Human adenoviruses (HAdV) comprise more than 100 genotypes with species-specific differences in tropism and immune response and can cause severe infections in immunocompromised patients. This study aimed to characterise the HAdV species involved in pediatric infections to assess their clinical impact and guide future therapeutic strategies based on AdV-specific T-cell responses. Between January and October 2024, 595 pediatric HAdV diagnoses were made at the Bambino Gesù Children's Hospital (Rome), and whole-genome sequencing was performed on 60 samples. Most patients (91.7%) were hospitalised, including both immunocompetent (75%) and immunocompromised (25%) children. Gastrointestinal and respiratory symptoms were more common in immunocompetent patients, whereas immunocompromised patients experienced longer hospitalisations and persistent viral infections. Species F (F41) was most prevalent (63.3%), especially among immunocompetent patients, while species C and A predominated in immunocompromised children, with species A associated with severe disease. Viral loads were significantly higher for species F than for species A and C, independent of immune status. Co-infections were frequent (63.3%), with species C particularly linked to them. In conclusion, HAdV distribution differed by immune status, with species F predominating in immunocompetent children and species C and A more common in immunocompromised patients. Whole-genome sequencing may enhance surveillance, enable earlier diagnosis, and support the development of genotype-specific immunotherapies.
