Fulminant Adenoviral-Induced Hepatitis in Immunosuppressed Patients

• Published in: Viruses Vol. 14; no. 7; p. 1459
• Main Authors: Kager, Juliane, Schneider, Jochen, Rasch, Sebastian, Herhaus, Peter, Verbeek, Mareike, Mogler, Carolin, Heim, Albert, Frösner, Gert, Hoffmann, Dieter, Schmid, Roland M, Lahmer, Tobias
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.07.2022; MDPI
• Subjects: acute liver failure; adenovirus; Adenoviruses, Human; Biopsy; Care and treatment; Case Report; Chemotherapy; Cidofovir; Complications and side effects; Computed tomography; Cytomegalovirus; Differential diagnosis; Emergency medical care; Epstein-Barr virus; Fever; Graft versus host disease; Hepatitis; Immunocompromised hosts; Immunoglobulins; Immunotherapy; Infections; Liver; Lymphoma; Medical imaging; Monoclonal antibodies; Patient outcomes; Patients; Pneumonia; Remission (Medicine); Risk factors; Rituximab; stem-cell transplantation; Transplantation; Germany
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v14071459

Human adenovirus (HAdV) can often lead to fulminant hepatitis in immunocompromised patients, mostly after reactivation of HAdV. Different risk factors, e.g., transplantation and chemotherapy, increase the risk of developing a HAdV hepatitis. We retrospectively analyzed three patients who showed the characteristics of a HAdV hepatitis observed in disseminated disease. In addition to PCR, diagnosis could be proven by pathology, CT scan, and markedly elevated transaminases. All patients had a hemato-oncologic underlying disease. Two had received a stem-cell transplant, and one was under chemotherapy including rituximab. Despite therapy with cidofovir, all patients died. As the incidence of HAdV hepatitis is low, diagnosis may be easily overlooked. No treatment approaches have yet been established. HAdV hepatitis should be considered as a differential diagnosis, especially when risk factors are present. To avoid dissemination, treatment should be initiated as soon as possible.