Journal Article

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

Bianca Heemskerk, Arjan C. Lankester, Tamara van Vreeswijk, Matthias F. C. Beersma, Eric C. J. Claas, Louise A. Veltrop-Duits, Aloys C. M. Kroes, Jaak M. J. J. Vossen, Marco W. Schilham and Maarten J. D. van Tol

in The Journal of Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 191, issue 4, pages 520-530
Published in print February 2005 | ISSN: 0022-1899
Published online February 2005 | e-ISSN: 1537-6613 | DOI: http://dx.doi.org/10.1086/427513
Immune Reconstitution and Clearance of Human Adenovirus Viremia in Pediatric Stem-Cell Recipients

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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.

Journal Article.  6004 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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