Incidence of Adenoviral DNAemia in Polish Adults Undergoing Allogeneic Haematopoietic Stem Cell Transplantation

Abstract

Human adenoviruses (HAdV) are important viral pathogens recognized increasingly in immunocompromised hosts, especially in allogeneic haematopoietic stem cell transplant recipients (alloHSCT). The clinical spectrum of HAdV disease ranges from asymptomatic viraemia and mild self-limiting disease to lower respiratory tract infection, multi-organ involvement and even death. Early detection and quantification of HAdV in peripheral blood using real-time PCR (qPCR) assay has been suggested as a useful monitoring tool, but is seldom used for regular surveillance of HAdV in haematology centers. A group of 112 alloHSCT recipients from two hospitals in Warsaw (Poland) was examined in the early post-transplant period using a quantitative qPCR assay. A total of 1,245 serum samples were evaluated for presence of HAdV DNA in patients where 66 (59%) patients received grafts from unrelated donors whereas the other 46 (41%) from sibling donors. HAdV sequences were detected in 64 (57%) of the 112 patients. In 22 of all patients (20%) HAdV DNA was detected only in a single positive sample, while 42 (37%) had positive results in two or more subsequent sera. In total, DNAemia was present in 202 sera samples (16%) with median time to observation of 47days. Graft-versus-host disease (GvHD) was observed in 18 (28%) adenovirus-infected transplant recipients and a significant correlation between HAdV infections and GvHD clinical presentation was found (p=0.018). There is a high prevalence of HAdV infections in HSCT recipients in Poland during early post-transplant period. In consequence, we could only speculate if HAdV DNAemia could be also related to GvHD symptoms, enforcing the important pathogenic role of these viral infections in clinical complications post-alloHSCT.