Immune Reconstitution and Clearance of Human Adenovirus Viremia in Pediatric Stem-Cell Recipients

• Published in: The Journal of infectious diseases Vol. 191; no. 4; pp. 520 - 530
• Main Authors: Heemskerk, Bianca, Lankester, Arjan C., Vreeswijk, Tamara van, Beersma, Matthias F. C., Claas, Eric C. J., Veltrop-Duits, Louise A., Kroes, Aloys C. M., Vossen, Jaak M. J. J., Schilham, Marco W., van Tol, Maarten J. D.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.02.2005; University of Chicago Press; Oxford University Press
• Subjects: Adenovirus Infections, Human - immunology; Adenovirus Infections, Human - virology; Adenoviruses; Adenoviruses, Human - immunology; Adenoviruses, Human - isolation & purification; Adolescent; Antibodies, Viral - blood; B lymphocytes; Biological and medical sciences; Blood; Bone marrow; CD4-Positive T-Lymphocytes - immunology; Child; Child, Preschool; DNA, Viral - blood; Female; Fundamental and applied biological sciences. Psychology; Human adenovirus; Humans; Infant; Infections; Infectious diseases; Lymphocyte Count; Lymphocytes; Lymphocytes - immunology; Male; Medical sciences; Microbiology; Miscellaneous; Mud; Neutralization Tests; Retrospective Studies; Stem Cell Transplantation; Survival; T lymphocytes; Transplantation; Viral Load; Viremia; Virology; Virus; Infection; Adenoviridae; Microbiology; Viremia; Viral disease; Human adenovirus; Stem cell; Mastadenovirus; Recipient; Clearance
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/427513

Background. Human adenovirus (HAdV) infections are increasingly frequent complications of allogeneic stem-cell transplantation (SCT), especially in children. Only a few data on the correlation between immune recovery and the course of HAdV infection are available, and data on HAdV-specific responses are lacking. Methods. In a prospective study, we determined the correlation between the HAdV DNA load in plasma and lymphocyte reconstitution in 48 children after allogeneic SCT. Additionally, HAdV-specific humoral and cellular immune responses were investigated. Results. HAdV infection occurred in 21 patients (44%), and, in 6 of these patients, the infection progressed to viremia, as demonstrated by the presence of HAdV DNA in plasma. Low lymphocyte counts at the onset of infection were predictive of HAdV viremia. Survival of patients with HAdV viremia was associated with an increase in lymphocyte counts during the first weeks after infection. In these patients, HAdV-specific CD4+ T cell responses, as well as increases in titers of neutralizing antibody, were detected after clearance of HAdV DNA from plasma. >Conclusions. Lymphocyte reconstitution appears to play a crucial role in clearance of HAdV viremia and survival of the host, warranting further development of therapeutic interventions aimed at improving immune recovery.