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Published on: December 10, 2013
Adenovirus Types in US Children Hospitalized or Seen in the Emergency Department With Acute Respiratory Illness,
Tess Stopczynski1, Varvara Probst2, Adam Gailani2
1Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
Human adenovirus (HAdV) causes pediatric acute respiratory illness (ARI). HAdV-B7 infections are linked to more severe outcomes in children, highlighting the importance of type-specific analysis for targeted interventions.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Public Health
Background:
- Human adenovirus (HAdV) is a significant cause of pediatric acute respiratory illness (ARI) globally.
- Clinical presentations of HAdV infections differ based on species and type.
- Understanding type-specific disease patterns is crucial for developing targeted interventions.
Purpose of the Study:
- To characterize human adenovirus (HAdV) types causing pediatric ARI.
- To investigate the association between specific HAdV types and disease severity.
- To identify type-specific clinical manifestations and outcomes in children with ARI.
Main Methods:
- A multicenter, prospective study enrolled children (<18 years) with ARI at 7 US children's hospitals.
- Respiratory specimens were tested for HAdV, and positive samples underwent hexon gene sequencing for typing.
- Generalized linear mixed effects models were used to compare HAdV types and evaluate disease severity.
Main Results:
- Of 1843 HAdV-positive cases, 1402 (76%) were typed, with HAdV-C1, HAdV-C2, and HAdV-B3 being most common.
- Children infected with HAdV-B7 showed significantly higher odds of severe outcomes (aOR = 2.05).
- Symptom presentation varied by HAdV type, with species B cases exhibiting more non-respiratory symptoms.
Conclusions:
- HAdV-B7 infection in children is associated with an increased risk of severe outcomes.
- Significant heterogeneity exists in clinical presentation and severity among different HAdV types.
- HAdV type is an important factor for future prevention and treatment strategies for pediatric ARI.
Background:
Human adenovirus (HAdV) is a common cause of pediatric acute respiratory illness (ARI), contributing to 5-13% of cases worldwide. Clinical manifestations vary by HAdV species and type; therefore, delineating type-specific disease presentations and understanding severity of specific HAdV types' disease may help develop targeted interventions.
Methods:
We conducted a multicenter, prospective study within the New Vaccine Surveillance Network to characterize HAdV types. Children <18 years old with ARI were enrolled in the emergency department or inpatient setting at 7 US children's hospitals from 1 December 2016 to 30 November 2019. Respiratory specimens were collected and tested for HAdV and other viruses. Subsequently, typing was conducted on HAdV specimens using single-plex real-time PCR assays targeting sequences in the hexon gene. Comparisons between HAdV types were performed to determine differences in characteristics and outcomes. Generalized linear mixed effects models were used to evaluate severity.
Results:
Among the 1843 HAdV-positive cases, 1402 specimens (76%) were typed. The most common types detected were HAdV-C1 (n = 439), HAdV-C2 (n = 393), and HAdV-B3 (n = 221). Children with HAdV-B7 (n = 78) had higher odds of severe outcomes compared to those with other HAdV types (aOR = 2.05; 95% CI: 1.24, 3.40). Symptom presentation varied across types within species B, C, and E; while all species had high frequency of upper respiratory symptoms, species B cases presented with a higher frequency of non-respiratory manifestations.
Conclusions:
Among children with HAdV-positive ARI, those with HAdV-B7 had higher odds of severe outcomes. These findings suggest heterogeneity in clinical presentation and severity among HAdV types, emphasizing the importance of HAdV type in future prevention and treatment strategies.
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