Adenoviruses in the immunocompromised host

ECHAVARRIA M

Clinical Microbiology Reviews

ASM Press

Lugar: ASM Press Impact Factor 15.764; Año: 2008 vol. 21 p. 704 - 715

SUMMARY The number of patients with acquired immunodeficiency has grown steadily as a result of both a higher number of patients receiving solid organ and hematopoietic stem cell transplants and their longer survival. The use of newer more potent immunosuppressive regimens  has increased the frequency of severe adenovirus infections. Human adenoviruses are a large group of viruses represented by at least 52 serotypes with various genotypes divided in genomic clusters, which may cause a broad variety of clinical manifestations. The development of molecular methods has increased sensitivity and rapidity  for adenovirus diagnosis. The implementation of PCR assays has significantly contributed to the identification of patients with disseminated adenovirus disease.  More recently, the development of real time PCR assays has permitted virus quantification and patients´ follow-up. There is no treatment for adenovirus with demonstrated efficacy although cidofovir is widely used. Sensitive diagnostic tests for adenovirus can contribute to the early detection and successful treatment of life-threatening adenovirus infections especially in complex immunocompromised patients. The development of improved adenovirus therapy still remains a challenge. Adenoviruses genetic diversity should be considered for diagnosis, typing and therapeutic interventions.