Abstract
Human adenovirus (HAdV) cause upper and lower respiratory tract infections. However, there are few large prospective studies focused on HAdVs acute infections requiring hospitalization. From 2005 to 2013 a prospective study was conducted on children admitted with acute respiratory infections. Specimens of nasopharyngeal aspirate were taken for virological study by PCR and clinical data was recorded. HAdV specimens were genotyped. Frequency and clinical course of HAdV infections were compared with RSV, rhinovirus (RV), human bocavirus (HBoV) and influenza in the same population. HAdV was detected in 403 cases of 2371 confirmed viral infections (17.2%) , of which 154 were single virus infections (38%). We genotyped 154 HAdVs. The most frequent genotypes were HAdV-3 (24%), HAdV-6 (21%), and HAdV-5 (20%). A total of 262 children had fever (64.9%); 194 suffered hypoxia (48%), and 147 presented infiltrate in chest x-rays (36.4%). The most frequent diagnoses were recurrent wheezing or asthma (51.7%), bronchiolitis (18.3 %), and pneumonia (11.9%), and 46 (11.4%) episodes required prolonged hospitalization (>7 days) due to the severity. Adenovirus single infections were compared with single infections of 598 RSV, 494 RV, 83 influenza and 78 HBoV. Significant clinical differences were found between HAdV, RSV and RV infections.
Highlights
Human adenovirus (HAdV), a double-stranded DNA virus, causes a wide range of clinical syndromes and is a well-recognized agent of upper and lower respiratory infections in children [1,2]
We compared clinical data among the four more prevalent genotypes (HAdV 2,3,5,6) and we found that patients infected with genotype HAdV-3 had higher C-reactive protein levels than those infected with genotype HAdV-5 (47.8 ± 37) vs 16.9(SD 15), p = 0.05) and longer duration of the fever than those with genotype HAdV-6 (4.7 ± 3 vs 2.9 ±1.5, p = 0.06)
HAdV infections are found in an important proportion of the hospitalized children with respiratory illnesses (17% in our series), and circulate mainly in spring and December
Summary
Human adenovirus (HAdV), a double-stranded DNA virus, causes a wide range of clinical syndromes and is a well-recognized agent of upper and lower respiratory infections in children [1,2]. Less frequently adenoviruses can cause gastrointestinal, ophthalmologic, genitourinary and neurological infections. HAdVs are classified into seven species, A to G [3]. Different serotypes may be implicated in different clinical syndromes. Serotypes 1,2,3,5 and 7 have been described to be associated with pharyngitis. Pharyngoconjuntival fever is usually caused by serotypes 2,3,4 and 7, and pneumonia has been related to 3,7 and 21 [2,4]. Less information exists about other lower respiratory syndromes such as bronchiolitis, recurrent wheezing or PLOS ONE | DOI:10.1371/journal.pone.0132162. Less information exists about other lower respiratory syndromes such as bronchiolitis, recurrent wheezing or PLOS ONE | DOI:10.1371/journal.pone.0132162 July 6, 2015
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