Clinical Information

Human adenoviruses (ADV) are ubiquitous, nonenveloped, double-stranded DNA viruses capable of infecting humans. ADV are classified into 7 species (A through G), and over 100 types based on serological and genetic analysis.(1) While infections can be asymptomatic, a variety of clinical presentations can occur following infection, in part due to differences in cell tropism across ADV types.(2) The most common clinical presentations include respiratory, gastrointestinal, and ocular infections.

Adenovirus infections are commonly acquired in early childhood, but infections and outbreaks have been reported in adult populations as well.(3) In immunocompetent individuals, infections are typically self-limiting and do not require medical intervention. However, there is a higher risk of more severe infection, including disseminated disease, in immunocompromised patients such as solid organ and hematopoietic stem cell transplant recipients.

In individuals at risk for severe disease, the most common diagnostic method is detection of the ADV DNA with various molecular assays, which have been developed to detect and quantify various ADV species and types associated with human disease.(2) Additionally, plasma specimens are used for diagnostic screening in high-risk transplant patients as a marker of dissemination. However, presence of ADV in non-blood specimens is not a definitive marker of disease, as it can be shed in urine, saliva, tears, or stool of asymptomatic patients.(3,4) Therefore, serial quantitative measurement of ADV viral load in plasma of high-risk patients is recommended to guide clinical management strategies, but there is no consensus on a definitive ADV viral load thresholds to guide therapeutic intervention.(3,4) Currently, the primary use of quantitative plasma ADV DNA assays is to monitor the trend of viral load over time as a surrogate for disease progression.