Clinical importance of adenoviral infections

Abstract

The aim of this article was to point to ubiquitous adenoviral infections and to give a literature overview. Adenoviral infections present with a variety of clinical manifestations, causing many differential diagnosis problems. In our country diagnosis is made using the complement fixation test (CFT), which detects antibodies due to soluble group specific antigen. In acute infections, we need two sera samples given in 2 weeks period with 4-fold rise or fall in titers. Due to many asymptomatic infections which can given increased titer by CFT, many physicians think that patients have a persistent infection. Persistent adenoviral infections need not be accompanied by any special clinical symptomatology. However, adenoviral infections still play an important role in acute respiratory infections. The most severe respiratory infection is pneumonia which can be associated with acute respiratory distress syndrome and death. Disseminated adenoviral diseases appear in 2.5% of all adenoviral infections with the same percentage between immunocompetent and immunocompromised persons. In immunocompromised persons adenoviral infections manifest as haemorrhagic cystitis, fulminant or acute hepatitis or meningoencephalitis. We still don't have a special treatment for these kinds of infections. Variety of antiviral drugs with controversial effects have been reported in management of adenoviral infections in immunocompromised persons. In USA adenoviral vaccine has been excluded from vaccine schedules among military personnel, but morbidity and the first two deaths due to these infections in the last 30 years reported by MMWR in 2000, may change this policy.