Occurrence of adenovirus infection and clinical impact in paediatric stem cell transplant recipients

n this study, the occurrence and clinical impact of adenovirus (AdV)infection was investigated in paediatric hematopoietic stem cell trans-plantation (HSCT) recipients. A number of 603 specimens (includingwhole blood, respiratory and other samples) from 181 patients weretested by real-time polymerase chain reaction; clinical outcome wasinvestigated. Overall, 118/603 (19.6%) specimens from 2 1/181 (11.6%)patients resulted positive to AdV (including 17.3, 29.9, 17.6, and 15.8%of total number of whole blood, respiratory, urine and other specimens,respectively). On whole blood specimens, viral loads ranged from <600(limit of detection) to >5×106 copies/mL, with a median value 2×104.Multiple specimens were positive in patients in which viral load onwhole blood was high. Adenoviral positivity o n whole blood was associ-ated to poor prognosis, as death occurred in three of ten (30%)patients with persistent positivity on whole blood specimens, alsodespite the administration of an antiviral agent (cidofovir).Adenovirus infection can account for systemic and/or organ-specificsigns/symptoms in approximately 10% of paediatric HSCT recipients.At moment, there is no indication for routine monitor of AdV in thesepatients, although AdV aetiology of infectious transplant complicationsshould be taken in account.